Provider Demographics
NPI:1255686333
Name:FAROKHI, FATMEH (EDD)
Entity Type:Individual
Prefix:
First Name:FATMEH
Middle Name:
Last Name:FAROKHI
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 LANDAU LN
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10977-1826
Mailing Address - Country:US
Mailing Address - Phone:845-426-6061
Mailing Address - Fax:845-517-4590
Practice Address - Street 1:21 LANDAU LANE
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10977
Practice Address - Country:US
Practice Address - Phone:845-426-6061
Practice Address - Fax:845-517-4590
Is Sole Proprietor?:No
Enumeration Date:2012-07-16
Last Update Date:2012-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY341440901174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist