Provider Demographics
NPI:1932399839
Name:DABIR, FARANAK (MD)
Entity Type:Individual
Prefix:DR
First Name:FARANAK
Middle Name:
Last Name:DABIR
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:PO BOX 820933
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19182-0933
Mailing Address - Country:US
Mailing Address - Phone:215-226-8800
Mailing Address - Fax:215-226-8819
Practice Address - Street 1:925 PROVIDENCE RD
Practice Address - Street 2:SUITE 8/9
Practice Address - City:SECANE
Practice Address - State:PA
Practice Address - Zip Code:19018-2920
Practice Address - Country:US
Practice Address - Phone:610-394-1234
Practice Address - Fax:610-284-4811
Is Sole Proprietor?:No
Enumeration Date:2007-07-26
Last Update Date:2015-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ37290207R00000X
PAMD433425207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102110891Medicaid
PACD4829OtherRAILROAD MEDICARE GROUP
PA597586OtherMEDICARE GROUP