| Doctor Name: | DR. HOORBOD DELSHADFAR |
| NPI Number: | 1629276597 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | 244818 |
| Business Practice Address: | 6902 Austin St 2 Forest Hills, NY - 113754250 |
| Business Phone Number: | 7187936800 |
| Business Fax Number: | 3473924179 |
| Mailing Address: | 10 Shore Dr, GREAT NECK |
| State: | NY |
| Postal Code: | 110211711 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 07/03/2007 |
| NPI Last Update Date: | 12/31/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 244818 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |