Provider Demographics
NPI:1497133615
Name:GORGANI, FARZAN (DO)
Entity Type:Individual
Prefix:DR
First Name:FARZAN
Middle Name:
Last Name:GORGANI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 RESEARCH WAY STE 13
Mailing Address - Street 2:
Mailing Address - City:EAST SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11733-3489
Mailing Address - Country:US
Mailing Address - Phone:631-444-4090
Mailing Address - Fax:631-444-4089
Practice Address - Street 1:33 RESEARCH WAY STE 13
Practice Address - Street 2:
Practice Address - City:EAST SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11733-3489
Practice Address - Country:US
Practice Address - Phone:631-444-4090
Practice Address - Fax:631-444-4089
Is Sole Proprietor?:No
Enumeration Date:2015-05-07
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYAS7163304207W00000X
OH34.013846207W00000X
NJ25MB11093500207W00000X
NY285137207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2697807Medicaid