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: Maria Ididzkowska Bi Apr 10. 2014 Bill For: Maria Idicincowska Date Transaction CPT Cade Diagnosis Total Owed Kamran Fallahpour, PhD License Number: 015910 Tax Id: 412054025 NPI: 1346320660 EFTA00306966