Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207N00000X | Dermatologist | 56103 | CT |
Y | 207ND0101X | MOHS-Micrographic Surgeon | 292029 | NY |
N | 207ND0101X | MOHS-Micrographic Surgeon | 56103 | CT |
N | 207NS0135X | Procedural Dermatology | 292029 | NY |
NPI | 1184966012 |
---|---|
Provider Name | Dr. Joshua Andrew Farhadian |
First Address | Bethpage, NY 11714-5706 |
Second Address | Bethpage, NY 11714-5706 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/03/2013 |
Last Update Date | 09/08/2020 |