Individual
FARHAD ANOOSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
55 MEDFORD AVE, SUITE D, PATCHOGUE, NY 11772-1229
(631) 687-5400
Mailing address
55 MEDFORD AVE, SUITE D, PATCHOGUE, NY 11772-1229
(631) 687-5400
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
046599
CT
208600000X
Surgery Physician
Primary
256590
NY
208600000X
Surgery Physician
A 113637
CA
208600000X
Surgery Physician
MD436039
PA
Other
Enumeration date
03/02/2009
Last updated
10/22/2012
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