Provider Demographics
NPI:1669769428
Name:BARZANI, GOLALEH (DMD FACS)
Entity type:Individual
Prefix:DR
First Name:GOLALEH
Middle Name:
Last Name:BARZANI
Suffix:
Gender:F
Credentials:DMD FACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 PALISADES DR STE 250
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12205-1448
Mailing Address - Country:US
Mailing Address - Phone:518-240-3750
Mailing Address - Fax:518-240-3759
Practice Address - Street 1:170 SARATOGA RD # 1
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12302-4513
Practice Address - Country:US
Practice Address - Phone:518-240-3750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-30
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY057247-011223S0112X
PADS0411561223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery