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Individual

FARSHAD BAGHERI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
13420 JAMAICA AVE, JAMAICA, NY 11418-2619
(718) 206-6742
(718) 206-6905
Mailing address
80 MARCUS DR, PROVIDER ENROLLMENT, MELVILLE, NY 11747-4230
(631) 391-7889
(631) 454-4161

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
002101
NY
207R00000X
Internal Medicine Physician
251743
NY
207RI0200X
Infectious Disease Physician
Primary
002101
NY
207RI0200X
Infectious Disease Physician
Primary
251743
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02652106
NY
Enumeration date
03/22/2006
Last updated
03/25/2026
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