Provider Demographics
NPI:1326428152
Name:KHARAZI, FARIBA (DO)
Entity Type:Individual
Prefix:
First Name:FARIBA
Middle Name:
Last Name:KHARAZI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 OSTRUM ST
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18015-1000
Mailing Address - Country:US
Mailing Address - Phone:610-628-7111
Mailing Address - Fax:338-201-0038
Practice Address - Street 1:2550 PA ROUTE 100
Practice Address - Street 2:SUITE 220
Practice Address - City:MACUNGIE
Practice Address - State:PA
Practice Address - Zip Code:18062-9600
Practice Address - Country:US
Practice Address - Phone:610-628-7111
Practice Address - Fax:833-820-1003
Is Sole Proprietor?:No
Enumeration Date:2015-06-06
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS020774207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine