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NPI Code Detail

MEDICARE: FAAN MEDICAL SERVICES PC

MEDICARE: FAAN MEDICAL SERVICES PC
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
1208VP0000XPain Medicine Physician238298NY

General Provider Information

NPI Number : 1073936308
Entity Type Code : Organization
Provider Name (Legal Business Name) : FAAN MEDICAL SERVICES PC
Provider Business Mailing Address
First Line : 278 PARK AVE
Second Line :
City : WILLISTON PARK
State : NY
Zip : 11596-1135
Country : US
Telephone Number : 718-739-7400
Fax Number : 718-739-7413
Provider Business Practice Location Address
First Line : 16806 HILLSIDE AVE
Second Line :
City : JAMAICA
State : NY
Zip : 11432-4341
Country : US
Telephone Number : 718-739-7400
Fax Number : 718-739-7413
Authorized Official
Title or Position : PRESIDENT
Name : KHONDEKER RAHMAN
Credential : MD
Telephone Number : 718-739-7400
Provider Enumeration Date : 01/22/2014
Last Update Date : 02/19/2015

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Directions to “FAAN MEDICAL SERVICES PC ” Practice Location

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