Provider Demographics
NPI:1750485942
Name:FARKHANI, HASAN (MD)
Entity Type:Individual
Prefix:
First Name:HASAN
Middle Name:
Last Name:FARKHANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525B EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:COLONIAL BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:22443-1907
Mailing Address - Country:US
Mailing Address - Phone:804-224-7890
Mailing Address - Fax:804-224-7893
Practice Address - Street 1:525B EUCLID AVE
Practice Address - Street 2:
Practice Address - City:COLONIAL BEACH
Practice Address - State:VA
Practice Address - Zip Code:22443-1907
Practice Address - Country:US
Practice Address - Phone:804-224-7890
Practice Address - Fax:804-224-7893
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-11
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101236651207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010287626Medicaid
VA010287626Medicaid
VAP00243221Medicare PIN
VAI27680Medicare UPIN