Provider Demographics
NPI:1932281920
Name:FARHI, FARIDEH (MD)
Entity Type:Individual
Prefix:
First Name:FARIDEH
Middle Name:
Last Name:FARHI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1084 ROUTE 315
Mailing Address - Street 2:
Mailing Address - City:WILKES-BARRE
Mailing Address - State:PA
Mailing Address - Zip Code:18702-7012
Mailing Address - Country:US
Mailing Address - Phone:570-825-8741
Mailing Address - Fax:570-825-8990
Practice Address - Street 1:404 RIDGE STREET
Practice Address - Street 2:FREELAND HEALTH CENTER
Practice Address - City:FREELAND
Practice Address - State:PA
Practice Address - Zip Code:18224-1805
Practice Address - Country:US
Practice Address - Phone:570-636-1556
Practice Address - Fax:570-636-0985
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD044294L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
718390ESUMedicare ID - Type Unspecified
F23179Medicare UPIN