Provider Demographics
NPI:1932292075
Name:MASANI, FARHAN N (DPM)
Entity Type:Individual
Prefix:DR
First Name:FARHAN
Middle Name:N
Last Name:MASANI
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 OLD COUNTRY RD
Mailing Address - Street 2:SUITE 2G
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590
Mailing Address - Country:US
Mailing Address - Phone:516-334-7642
Mailing Address - Fax:516-334-7642
Practice Address - Street 1:530 OLD COUNTRY RD
Practice Address - Street 2:SUITE 2G
Practice Address - City:WESTBURY
Practice Address - State:NY
Practice Address - Zip Code:11590
Practice Address - Country:US
Practice Address - Phone:516-334-7642
Practice Address - Fax:516-334-7642
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2015-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN005018213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01477412Medicaid
NYP60291Medicare PIN
NY01477412Medicaid