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1114174513

NPI Code Detail

MEDICARE: FARZIN RAHMANOU D.O

MEDICARE: FARZIN RAHMANOU D.O

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RP1001X	Pulmonary Disease Physician	257209	NY
2	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	257209	NY
3	207R00000X	Internal Medicine Physician	257209	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4578	OTHER	WV	STATE LICENSE
2	OS024547	OTHER	PA	STATE LICENSE
3	10229235	OTHER	VA	STATE LICENSE
4	H0102751	OTHER	MD	STATE LICENSE
5	02008222A	OTHER	IN	STATE LICENSE
6	257209	OTHER	NY	STATE LICENSE
7	34.017631	OTHER	OH	STATE LICENSE

General Provider Information

NPI Number	:	1114174513
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FARZIN RAHMANOU D.O

Provider Business Mailing Address
First Line	:	101 SAINT ANDREWS LN
Second Line	:
City	:	GLEN COVE
State	:	NY
Zip	:	11542-2263
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	101 SAINT ANDREWS LN
Second Line	:
City	:	GLEN COVE
State	:	NY
Zip	:	11542-2263
Country	:	US
Telephone Number	:	516-674-7300
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/27/2008
Last Update Date	:	06/11/2026

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Directions to “ FARZIN RAHMANOU D.O” Practice Location

Language	Start Address	Practice Location

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