Kamran Fallahpour, PhD
263 Westend Ave Suite 1D
New York, NY 10023
Bill To: Bill For:
Bffias of: Apr 10. 2014
Date Transaction CPT Cade Diagnosis Total Owed
4/9/2014 90792 $3.500.00
4/9/2014 Payment-, (53.500.00)
$0.00
Please Pay this Amount: $0.00
Charges for services to be rendered. please pay balance before neurological testing appointment.
Kamran Fallahpour, PhD
License Number: 015910
Tax Id: 412054025
NPI: 1346320660
EFTA00306965
Kamran Fallahpour, PhD
263 Westend Ave Suite 1D
New York, NY 10023
(212)877-2130
Bill To: Bill For:
Maria Ididzkowska Maria Idicincowska
Bi Apr 10. 2014
Date Transaction CPT Cade Diagnosis Total Owed
Kamran Fallahpour, PhD
License Number: 015910
Tax Id: 412054025
NPI: 1346320660
EFTA00306966