MEDICARE: INTERMED MEDICAL NY 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
1	207UN0901X	Nuclear Cardiology Physician
2	207R00000X	Internal Medicine Physician	251936	NY

General Provider Information

NPI Number	:	1316308406
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTERMED MEDICAL NY PC

Provider Business Mailing Address
First Line	:	236 BROADWAY
Second Line	:	SUITE 211
City	:	BROOKLYN
State	:	NY
Zip	:	11211-8414
Country	:	US
Telephone Number	:	718-633-2455
Fax Number	:	718-633-2466

Provider Business Practice Location Address
First Line	:	2329 NOSTRAND AVE STE 600
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11210-3948
Country	:	US
Telephone Number	:	718-633-2455
Fax Number	:

Authorized Official
Title or Position	:	MD
Name	:	FARZAD HAGHIGHI
Credential	:	MD
Telephone Number	:	929-289-0597

Provider Enumeration Date	:	03/16/2016
Last Update Date	:	11/12/2024

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