Provider Demographics
NPI:1144356668
Name:RAZMZAN, SHAHRAM (MD)
Entity type:Individual
Prefix:DR
First Name:SHAHRAM
Middle Name:
Last Name:RAZMZAN
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 1:2700 WESTCHESTER AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:PURCHASE
Mailing Address - State:NY
Mailing Address - Zip Code:10577-2547
Mailing Address - Country:US
Mailing Address - Phone:914-607-5730
Mailing Address - Fax:
Practice Address - Street 1:1084 N BROADWAY
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-1107
Practice Address - Country:US
Practice Address - Phone:914-848-8640
Practice Address - Fax:914-848-8641
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2018-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY169981207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000000045332OtherGHI HMO
NY03E602OtherEMPIRE BCBS OF NY BROADWAY
NY0D4673OtherHEALTHNET
NY160006708OtherRAILROAD MEDICARE
NYWP552OtherOXFORD
NY0062693OtherGHI PPO
NY01025194Medicaid
NY0098155OtherAETNA HMO
NY03E601OtherEMPIRE BCBS OF NY YONKERS
NY169981OtherHIP
NY4216732OtherAETNA PPO
NY03E60X0371Medicare PIN
NY0098155OtherAETNA HMO