Provider Demographics
NPI:1841209244
Name:EAST COAST PHYSICIANS PC
Entity Type:Organization
Organization Name:EAST COAST PHYSICIANS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:HASAN
Authorized Official - Middle Name:
Authorized Official - Last Name:FARKHANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-224-7890
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:
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:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101236651207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010360111Medicaid
VA010360111Medicaid
VAC10208Medicare PIN