Provider Demographics
NPI:1578732657
Name:FARHAN N MASANI DPM PC
Entity Type:Organization
Organization Name:FARHAN N MASANI DPM PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESEIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FARHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MASANI
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:516-334-7642
Mailing Address - Street 1:530 OLD COUNTRY RD
Mailing Address - Street 2:SUITE 2G
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590-4500
Mailing Address - Country:US
Mailing Address - Phone:516-334-7642
Mailing Address - Fax:516-334-7642
Practice Address - Street 1:530 OLD COUNTRY RD
Practice Address - Street 2:SUITE 2G
Practice Address - City:WESTBURY
Practice Address - State:NY
Practice Address - Zip Code:11590-4500
Practice Address - Country:US
Practice Address - Phone:516-334-7642
Practice Address - Fax:516-334-7642
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-22
Last Update Date:2016-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005018213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY4753760001Medicare NSC