Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 214924 | NY |
NPI | 1003911132 |
---|---|
Provider Name | Dr. Farshad Shafizadeh |
First Address | New York, NY 10016-6822 |
Second Address | New York, NY 10016-6822 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2006 |
Last Update Date | 28/03/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02190334 | (05) | NY |
H37635 | (02) | NY |