Provider Demographics
NPI:1730265000
Name:MOTAMED, DAVID BIJAN (RPA-C)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:BIJAN
Last Name:MOTAMED
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Gender:M
Credentials:RPA-C
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Mailing Address - Street 1:ONE GUSTAVE LEVY PLACE
Mailing Address - Street 2:MOUNT SINAI MEDICAL CENTER
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029
Mailing Address - Country:US
Mailing Address - Phone:212-241-0034
Mailing Address - Fax:212-289-7738
Practice Address - Street 1:ONE GUSTAVE LEVY PLACE
Practice Address - Street 2:MOUNT SINAI MEDICAL CENTER
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029
Practice Address - Country:US
Practice Address - Phone:212-241-0034
Practice Address - Fax:212-289-7738
Is Sole Proprietor?:No
Enumeration Date:2006-10-30
Last Update Date:2023-03-07
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Provider Licenses
StateLicense IDTaxonomies
NY011091363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY698866OtherMMIS
NM233049OtherNBHN
NY011091OtherPA LICENSE
NY011091OtherPA LICENSE