Provider Demographics
NPI:1184966012
Name:FARHADIAN, JOSHUA ANDREW (MD)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:ANDREW
Last Name:FARHADIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1000 NORTHERN BLVD STE 140
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-5312
Mailing Address - Country:US
Mailing Address - Phone:516-846-3300
Mailing Address - Fax:516-846-3305
Practice Address - Street 1:1000 NORTHERN BLVD STE 140
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-5312
Practice Address - Country:US
Practice Address - Phone:516-846-3300
Practice Address - Fax:516-846-3305
Is Sole Proprietor?:No
Enumeration Date:2013-03-18
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT56103207N00000X, 207ND0101X
NY292029207NS0135X, 207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology