Provider Demographics
NPI:1134297005
Name:NABATIAN, FARZAD (MD)
Entity Type:Individual
Prefix:
First Name:FARZAD
Middle Name:
Last Name:NABATIAN
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 1:14 HEYWARD ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11249-7823
Mailing Address - Country:US
Mailing Address - Phone:718-260-4600
Mailing Address - Fax:718-852-0867
Practice Address - Street 1:14 HEYWARD ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11249-7823
Practice Address - Country:US
Practice Address - Phone:718-260-4600
Practice Address - Fax:718-852-0867
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2012-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY167638207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0033467OtherGHI
NY4241153OtherAETNA
NYNP238OtherOXFORD HEALTH PLANS
NY0000000119315OtherGHI HMO
NY010167638NY01OtherANTHEM
NY0770793000OtherAMERIHEALTH
NY0C4237OtherHEALTH NET OF NEW YORK
NY119315OtherWELLCARE
NY167638OtherHIP
NY167638-NYOther1199 NBF
NY167638-NYOther1199 NBF
NY4241153OtherAETNA