Provider Demographics
NPI:1700837432
Name:NEZHAT, FARR (MD)
Entity Type:Individual
Prefix:DR
First Name:FARR
Middle Name:
Last Name:NEZHAT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:FARR
Other - Middle Name:
Other - Last Name:NEZHAT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:70 E SUNRISE HWY STE 515W
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11581-1233
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:70 E SUNRISE HWY STE 515W
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11581-1233
Practice Address - Country:US
Practice Address - Phone:516-663-1365
Practice Address - Fax:516-710-7685
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2018-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY158900-1207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1271538OtherMSNYU HEALTH TOP TIER UHC
NY01769355Medicaid
NY44G891Medicare PIN
NYD30350Medicare UPIN