Provider Demographics
NPI:1174816094
Name:ALAEE, FARHANG (MD)
Entity Type:Individual
Prefix:DR
First Name:FARHANG
Middle Name:
Last Name:ALAEE
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 1:500 CHASE PKWY
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06708-3346
Mailing Address - Country:US
Mailing Address - Phone:203-755-6677
Mailing Address - Fax:203-573-9182
Practice Address - Street 1:9101 FRANKLIN SQUARE DR STE 200
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21237-4072
Practice Address - Country:US
Practice Address - Phone:443-777-6788
Practice Address - Fax:443-777-6787
Is Sole Proprietor?:No
Enumeration Date:2011-05-25
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT061678207X00000X
MDD87689207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty