Provider Demographics
NPI:1205009701
Name:FARHAD SALARI-LAK
Entity Type:Organization
Organization Name:FARHAD SALARI-LAK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FARHAD
Authorized Official - Middle Name:
Authorized Official - Last Name:SALARI-LAK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:814-341-5222
Mailing Address - Street 1:PO BOX 340
Mailing Address - Street 2:
Mailing Address - City:IRWIN
Mailing Address - State:PA
Mailing Address - Zip Code:15642-0340
Mailing Address - Country:US
Mailing Address - Phone:814-341-5222
Mailing Address - Fax:724-864-4975
Practice Address - Street 1:350 WAYLAND SMITH DR
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15401-0340
Practice Address - Country:US
Practice Address - Phone:814-341-5222
Practice Address - Fax:724-864-4975
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-07
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD036859L207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0009493500019Medicaid
PA076419Medicare PIN
PA0009493500019Medicaid