Azizzadeh, Farhad
Azizzadeh, Farhad is an sole proprietor health care provider with primary practice located at 96 09 Springfield Blvd Suite 206, Queens Village NY 11429. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Azizzadeh, Farhad can be contacted via phone (718) 470-7700.Contact Information
Primary practice address
96 09 Springfield Blvd Suite 206
Queens Village NY 11429
Phone: (718) 470-7700
Fax: (718) 740-8005
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | 046904 | New York |
Profile Details
| NPI number | 1588648828 |
|---|---|
| LBN Legal business name | Azizzadeh, Farhad |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 30th, 2005 |
| Last updated | Nov 13th, 2014 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1588648828 | NPPES |
| New York | MEDICAID | 01925382 |
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