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Individual

FARZANEH MASOOL TONDKAR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
10731 W FOREST HOME AVE, HALES CORNERS, WI 53130-2555
(414) 529-4600
(414) 529-4689
Mailing address
10731 WEST FOREST HOME AVENUE, HALES CORNERS, WI 53130-2555
(414) 529-4600
(414) 529-4689

Taxonomy

Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
52372020
WI
208D00000X
General Practice Physician
52372020
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1434
WI
Enumeration date
01/09/2009
Last updated
10/03/2023
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