Individual
FARHANG F EBRAHIMI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1550 RICHMOND AVE, SUITE 205, STATEN ISLAND, NY 10314
(718) 982-7800
(718) 982-7722
Mailing address
97 NEW DORP LN STE A, STATEN ISLAND, NY 10306-2364
(718) 876-6220
(718) 876-5969
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
209072
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01905724
—
NY
01
—
A400123412
MEDICARE
NY
Enumeration date
08/31/2006
Last updated
07/19/2018
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