MEDICARE: DR. FARAIDOON DANIEL GOLYAN DO

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	207RC0000X	Cardiovascular Disease Physician	190702	NY

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	:	1174559926
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FARAIDOON DANIEL GOLYAN DO

Provider Business Mailing Address
First Line	:	6902 AUSTIN ST
Second Line	:	2ND FLOOR
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-4250
Country	:	US
Telephone Number	:	718-793-6800
Fax Number	:	718-261-4312

Provider Business Practice Location Address
First Line	:	6902 AUSTIN ST
Second Line	:	2ND FLOOR
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-4250
Country	:	US
Telephone Number	:	718-793-6800
Fax Number	:	718-261-4312

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

Provider Enumeration Date	:	06/23/2006
Last Update Date	:	11/07/2017

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