Mokhtari, Forough B

Mokhtari, Forough B is an individual health care provider with primary practice located at 5 Squiretown Road South Hampton Pediatric, Southampton NY 11946. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Mokhtari, Forough B can be contacted via phone (631) 728-5300.

Contact Information

Primary practice address
5 Squiretown Road South Hampton Pediatric Southampton NY 11946
Phone: (631) 728-5300
Fax: (631) 728-5360
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 221651 New York

Profile Details

NPI number 1134138357
LBN Legal business name Mokhtari, Forough B
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 5th, 2006
Last updated Nov 2nd, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134138357 NPPES
New York MEDICAID 02290628

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