Provider Demographics
NPI:1194157693
Name:DAYANI, FARSIMA (DO)
Entity type:Individual
Prefix:DR
First Name:FARSIMA
Middle Name:
Last Name:DAYANI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:FARSIMA
Other - Middle Name:
Other - Last Name:RAHMANOU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:PO BOX 234628
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11023-4628
Mailing Address - Country:US
Mailing Address - Phone:516-946-1719
Mailing Address - Fax:
Practice Address - Street 1:259 FIRST STREET
Practice Address - Street 2:DEPARTMENT OF PEDIATRICS, WINTHROP
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501
Practice Address - Country:US
Practice Address - Phone:516-946-1719
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-07
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY233995-1208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics