Individual
DR. FARSHAD HAIIMPOUR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D
Contact information
Practice address
8914 SUTPHIN BLVD, JAMAICA, NY 11435-3715
(718) 739-8939
Mailing address
8914 SUTPHIN BLVD, JAMAICA, NY 11435-3715
(718) 739-8939
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
T006102
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01975960
—
NY
01
—
76754121
AETNA
—
01
—
P2141131
OXFORD
NY
Enumeration date
01/17/2007
Last updated
06/15/2010
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