Basic Information
| Provider Information | |||||||||
| NPI: | 1891053328 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PEYMAN YOUNESI MD PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3307 164TH ST | ||||||||
| Address2: | SUITE #2 | ||||||||
| City: | FLUSHING | ||||||||
| State: | NY | ||||||||
| PostalCode: | 113581441 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3477093133 | ||||||||
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| Practice Location | |||||||||
| Address1: | 6136 170TH ST APT M4 | ||||||||
| Address2: | |||||||||
| City: | FRESH MEADOWS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 113651957 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7187090940 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/03/2012 | ||||||||
| LastUpdateDate: | 11/29/2021 | ||||||||
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| AuthorizedOfficialLastName: | YOUNESI | ||||||||
| AuthorizedOfficialFirstName: | PEYMAN | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 3107091236 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
| NPICertificationDate: | 11/29/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 2581181 | NY | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.