Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RP1001X | Pulmonary Disease | 109689 | FL |
N | 207RP1001X | Pulmonary Disease | 247648 | NY |
NPI | 1013076470 |
---|---|
Provider Name | Dr. Sam Michael Faradyan |
First Address | West Palm Beach, FL 33401-6349 |
Second Address | West Palm Beach, FL 33401-6349 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/12/2006 |
Last Update Date | 17/07/2012 |