Azizzadeh, Farhad

Azizzadeh, Farhad is an sole proprietor health care provider with primary practice located at 96 09 Springfield Blvd Suite 206, Queens Village NY 11429. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Azizzadeh, Farhad can be contacted via phone (718) 470-7700.

Contact Information

Primary practice address
96 09 Springfield Blvd Suite 206 Queens Village NY 11429
Fax: (718) 740-8005
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 046904 New York

Profile Details

NPI number 1588648828
LBN Legal business name Azizzadeh, Farhad
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 30th, 2005
Last updated Nov 13th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1588648828 NPPES
New York MEDICAID 01925382

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