Provider Demographics
NPI:1851491930
Name:TALEBIAN, FARHAD (MD)
Entity Type:Individual
Prefix:
First Name:FARHAD
Middle Name:
Last Name:TALEBIAN
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 1:877 STEWART AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-4803
Mailing Address - Country:US
Mailing Address - Phone:516-222-2121
Mailing Address - Fax:516-745-1445
Practice Address - Street 1:877 STEWART AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-4803
Practice Address - Country:US
Practice Address - Phone:516-222-2121
Practice Address - Fax:516-745-1445
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY113832174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY562941Medicare ID - Type Unspecified