Provider Demographics
NPI:1356739460
Name:KOOHSARI, SUNEYE (MD)
Entity type:Individual
Prefix:DR
First Name:SUNEYE
Middle Name:
Last Name:KOOHSARI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 W 37TH ST STE 701
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10018-6222
Mailing Address - Country:US
Mailing Address - Phone:212-651-9197
Mailing Address - Fax:917-967-9367
Practice Address - Street 1:5 W 37TH ST STE 701
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10018-6222
Practice Address - Country:US
Practice Address - Phone:212-651-9197
Practice Address - Fax:917-967-9367
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-26
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY277181-1207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine