Individual
FARSHAD MANSOURI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
741 TEANECK RD, SUITE B, TEANECK, NJ 07666-4243
(716) 523-7930
Mailing address
741 TEANECK RD, SUITE B, TEANECK, NJ 07666-4243
(716) 523-7930
Taxonomy
Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
25MA08363900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25MA08363900
LICENSE
NJ
Enumeration date
07/31/2008
Last updated
11/01/2016
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