Provider Demographics
NPI:1033470414
Name:NABIZADEH, FARBOD (MD)
Entity Type:Individual
Prefix:DR
First Name:FARBOD
Middle Name:
Last Name:NABIZADEH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 CHELSEA AVE
Mailing Address - Street 2:APT 412
Mailing Address - City:LONG BRANCH
Mailing Address - State:NJ
Mailing Address - Zip Code:07740-8109
Mailing Address - Country:US
Mailing Address - Phone:347-721-5147
Mailing Address - Fax:
Practice Address - Street 1:12 STILLWATER AVE
Practice Address - Street 2:UNIT 1
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-3984
Practice Address - Country:US
Practice Address - Phone:207-945-6588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-02
Last Update Date:2015-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMD20415207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology