Provider Demographics
NPI:1689056632
Name:AMANI, FARHAD (DO)
Entity Type:Individual
Prefix:
First Name:FARHAD
Middle Name:
Last Name:AMANI
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 1:1443 HARTFORD AVE
Mailing Address - Street 2:
Mailing Address - City:JOHNSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02919-3224
Mailing Address - Country:US
Mailing Address - Phone:401-273-8100
Mailing Address - Fax:401-553-1072
Practice Address - Street 1:1443 HARTFORD AVE
Practice Address - Street 2:
Practice Address - City:JOHNSTON
Practice Address - State:RI
Practice Address - Zip Code:02919-3224
Practice Address - Country:US
Practice Address - Phone:401-273-8100
Practice Address - Fax:401-553-1072
Is Sole Proprietor?:No
Enumeration Date:2015-06-26
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDO40362084P0800X
RIDO011462084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry