Kamran Fallahpour, PhD
263 Westend Ave Suite 1D
New York, NY 10023
Bill To: Bill For:
Bill as of: Apr 10.2014
Date Transaction CPT Code Diagnosis Total Owed
4/912014 Clinical Intake/ Psychiatric Evalualit 90792 $3,500.00
4/912014 Payment -- (53.50B00)
$0.00
Please Pay this Amount: $0.00
Charges for services to be rendered. please pay balance before neurological testing appointment.
Tax ID
Kamran Fallahpour, PhD
License Number: 015910
Tax Id:M5
NPI: I
EFTA00602690
Kamran Fallahpour, PhD
263 Westend Ave Suite 1D
New York, NY 10023
(212)877-2130
Bill To: Bill For:
Bill as of: Apr 10. 2014
Date Transaction CPT Code Diagnosis Total Owed
Kamran Fallahpour, PhD
License Number: 015910
Tax
NPI:
EFTA00602691