Provider Demographics
NPI:1902082431
Name:FARZAN, SHERRY (MD)
Entity type:Individual
Prefix:DR
First Name:SHERRY
Middle Name:
Last Name:FARZAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SHERRY
Other - Middle Name:
Other - Last Name:FARZAN-KASHANI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:865 NORTHERN BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-5310
Mailing Address - Country:US
Mailing Address - Phone:516-622-5070
Mailing Address - Fax:
Practice Address - Street 1:865 NORTHERN BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-5310
Practice Address - Country:US
Practice Address - Phone:516-817-1420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-15
Last Update Date:2009-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY244398207RA0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0201XAllopathic & Osteopathic PhysiciansInternal MedicineAllergy & Immunology