MEDICARE: DR. FEREYDOON GHOBADI M.D.

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	207XS0106X	Orthopaedic Hand Surgery Physician	MA46248	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1912952607
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FEREYDOON GHOBADI M.D.

Provider Business Mailing Address
First Line	:	504 VALLEY RD
Second Line	:	SUITE 201
City	:	WAYNE
State	:	NJ
Zip	:	07470-3534
Country	:	US
Telephone Number	:	973-942-1315
Fax Number	:	973-942-8724

Provider Business Practice Location Address
First Line	:	504 VALLEY RD
Second Line	:	SUITE 201
City	:	WAYNE
State	:	NJ
Zip	:	07470-3534
Country	:	US
Telephone Number	:	973-942-1315
Fax Number	:	973-942-8724

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

Provider Enumeration Date	:	05/23/2006
Last Update Date	:	10/09/2012

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