Organization
INNOVATIVE MEDICAL CARE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BEHROUZ FARAHMANDPOUR DO (PRESIDENT)
(631) 940-0409
Entity
Organization
Contact information
Practice address
375 COMMACK RD UNIT A, DEER PARK, NY 11729-5522
(631) 940-1834
(631) 940-1834
Mailing address
375 COMMACK RD UNIT A, DEER PARK, NY 11729-5522
(631) 940-1834
(631) 940-1834
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
233446
NY
Other
Enumeration date
09/14/2010
Last updated
03/30/2025
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