Provider Demographics
NPI:1275641672
Name:LUKBAN, FARAHNAZ (MD)
Entity Type:Individual
Prefix:
First Name:FARAHNAZ
Middle Name:
Last Name:LUKBAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:FARAHNAZ
Other - Middle Name:
Other - Last Name:JOACHIM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:233 NOSTRAND AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11205-4924
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2832 LINDEN BLVD
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11208-5132
Practice Address - Country:US
Practice Address - Phone:718-240-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-26
Last Update Date:2010-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY238224207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine