Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | A118514 | CA |
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | A118514 | CA |
NPI | 1083999031 |
---|---|
Provider Name | Faranak Mohammadpour |
First Address | Yonkers, NY 10705 |
Second Address | Yonkers, NY 10705 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/10/2011 |
Last Update Date | 20/10/2011 |