MEDICARE: SINAI HADASSAH MEDICAL ASSOCIATE PLLC

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	207R00000X	Internal Medicine Physician	251936	NY
2	207R00000X	Internal Medicine Physician	A107845	CA
3	208M00000X	Hospitalist Physician	251936	NY

General Provider Information

NPI Number	:	1508165317
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SINAI HADASSAH MEDICAL ASSOCIATE PLLC

Provider Business Mailing Address
First Line	:	8904 63RD DR
Second Line	:
City	:	REGO PARK
State	:	NY
Zip	:	11374-3858
Country	:	US
Telephone Number	:	212-961-7462
Fax Number	:

Provider Business Practice Location Address
First Line	:	6902 AUSTIN ST
Second Line	:
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-4233
Country	:	US
Telephone Number	:	212-961-7462
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. FARZAD AVRAHAM HAGHIGHI
Credential	:	M.D.
Telephone Number	:	212-961-7362

Provider Enumeration Date	:	03/18/2011
Last Update Date	:	01/17/2017

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