MEDICARE: DR. FARZIN SEHATI D.O.

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	207Q00000X	Family Medicine Physician	204917	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	:	1477636389
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FARZIN SEHATI D.O.

Provider Business Mailing Address
First Line	:	PO BOX 234809
Second Line	:
City	:	GREAT NECK
State	:	NY
Zip	:	11023-4809
Country	:	US
Telephone Number	:	718-736-1450
Fax Number	:	718-736-1493

Provider Business Practice Location Address
First Line	:	6902 AUSTIN ST FL 3
Second Line	:
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-4233
Country	:	US
Telephone Number	:	718-263-1450
Fax Number	:	718-263-1454

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

Provider Enumeration Date	:	10/23/2006
Last Update Date	:	01/31/2019

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