MEDICARE: SORAYA RADFAR 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
1	2084P0800X	Psychiatry Physician	034142EPA	PA

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	:	1306832662
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SORAYA RADFAR MD

Provider Business Mailing Address
First Line	:	1847 TILTON DR
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15241-2636
Country	:	US
Telephone Number	:	412-341-5991
Fax Number	:	412-341-5994

Provider Business Practice Location Address
First Line	:	20 CEDAR BLVD
Second Line	:
City	:	MT LEBANON
State	:	PA
Zip	:	15228-1330
Country	:	US
Telephone Number	:	412-341-5991
Fax Number	:	412-341-5994

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

Provider Enumeration Date	:	09/22/2005
Last Update Date	:	12/03/2007

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