Provider Demographics
NPI:1316308406
Name:INTERMED MEDICAL NY PC
Entity type:Organization
Organization Name:INTERMED MEDICAL NY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:FARZAD
Authorized Official - Middle Name:
Authorized Official - Last Name:HAGHIGHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:929-289-0597
Mailing Address - Street 1:236 BROADWAY
Mailing Address - Street 2:SUITE 211
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11211-8414
Mailing Address - Country:US
Mailing Address - Phone:718-633-2455
Mailing Address - Fax:718-633-2466
Practice Address - Street 1:2329 NOSTRAND AVE STE 600
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11210-3948
Practice Address - Country:US
Practice Address - Phone:718-633-2455
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-16
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207UN0901X
NY251936207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear CardiologyGroup - Single Specialty