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NPI Code Detail

MEDICARE: DR. FARANAK EBRAHIMIAN SADABAD MD

MEDICARE: DR. FARANAK EBRAHIMIAN SADABAD MD
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
1390200000XStudent in an Organized Health Care Education/Training ProgramCT

General Provider Information

NPI Number : 1124961644
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. FARANAK EBRAHIMIAN SADABAD MD
Provider Business Mailing Address
First Line : 263 FARMINGTON AVE
Second Line :
City : FARMINGTON
State : CT
Zip : 06030-1921
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : UCONN HEALTH BRAIN & SPINE INSTITUTE 5 MUNSON ROAD MC
Second Line :
City : FARMINGTON
State : CT
Zip : 06030-0001
Country : US
Telephone Number : 860-679-4888
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2026
Last Update Date : 04/10/2026

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