Provider Demographics
NPI:1366524878
Name:TALEBIAN, BEHZAD (MD)
Entity type:Individual
Prefix:MR
First Name:BEHZAD
Middle Name:
Last Name:TALEBIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:877 STEWART AVE
Mailing Address - Street 2:SUITE 33
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-4803
Mailing Address - Country:US
Mailing Address - Phone:516-745-5621
Mailing Address - Fax:516-227-2544
Practice Address - Street 1:877 STEWART AVE
Practice Address - Street 2:SUITE 33
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-4803
Practice Address - Country:US
Practice Address - Phone:516-745-5621
Practice Address - Fax:516-227-2544
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY141420208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA96570Medicare UPIN