Provider Demographics
NPI:1558662049
Name:FARZAM KASHANIAN M.D., P.C
Entity Type:Organization
Organization Name:FARZAM KASHANIAN M.D., P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:FARZAM
Authorized Official - Middle Name:
Authorized Official - Last Name:KASHANIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-659-4339
Mailing Address - Street 1:2350 OCEAN AVE
Mailing Address - Street 2:MEDICAL SUITE #4
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-3030
Mailing Address - Country:US
Mailing Address - Phone:516-659-4339
Mailing Address - Fax:
Practice Address - Street 1:2350 OCEAN AVE
Practice Address - Street 2:MEDICAL SUITE #4
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-3030
Practice Address - Country:US
Practice Address - Phone:516-659-4339
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-15
Last Update Date:2010-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty