Provider Demographics
NPI:1568672160
Name:ALMASGANJ, FARNAZ (MD)
Entity Type:Individual
Prefix:
First Name:FARNAZ
Middle Name:
Last Name:ALMASGANJ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:FARNAZ
Other - Middle Name:ALMAS
Other - Last Name:GANJ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1650 4TH ST SE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55904-4717
Mailing Address - Country:US
Mailing Address - Phone:507-529-6600
Mailing Address - Fax:
Practice Address - Street 1:1650 4TH ST SE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55904-4717
Practice Address - Country:US
Practice Address - Phone:507-529-6600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY45252207V00000X
LAMD.202426207V00000X
IL036-132673207V00000X
IL036132673207VF0040X
MN75538207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyFemale Pelvic Medicine and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1065803Medicaid