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General NPI Number Information
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NPI Number | 1750797890
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Entity Type | Organization
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Legal Business Name | BEHROUZ FARAHMANDPOUR D.O.P.C.
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Dates
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Enumeration Date | 07/09/2014
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Last Update Date | 07/01/2025
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Provider Practice Location Address
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Address Line | 25 MELVILLE PARK RD STE 200B
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City | MELVILLE
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State | NY
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Zip | 11747-3156
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Country | US
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Telephone | 631-888-5957
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Fax | 631-940-5837
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Provider Business Mailing Address
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Address Line | 30 HAIGHT ST
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City | DEER PARK
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State | NY
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Zip | 11729-3135
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Country | US
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Telephone | 516-524-2213
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | BEHROUZ FARAHMANDPOUR
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Credential | DO
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Telephone | 516-524-2213
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 233446
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number | 233446
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License Number State | NY
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