Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
SAMIR DERISAVIFARD, MD
ActiveFemale Pelvic Medicine & Reconstructive Surgery · REGO PARK, NY
Registration Details
- NPI Number
- 1477997690
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Apr 18, 2013 (13.012904943206 yrs)
- Last Updated
- Jun 12, 2024
- Licenses
-
S5157 (TX)282292-01 (NY)282292-01 (NY)
Practice Information
- Address
-
9225 QUEENS BLVD FL 2REGO PARK, NY, 11374Browse NY providers · Browse ZIP 11374
- Phone
- 8179256200
- Primary Specialty
-
Female Pelvic Medicine & Reconstructive Surgery
2088F0040X
- Additional Specialty
- Urology
- Additional Specialty
- Female Pelvic Medicine & Reconstructive Surgery
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.