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1376177428
MISAGH FASAZADEH
GREAT NECK, NY
NPI
1376177428
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363A00000X Physician Assistant
(Licence: NY 025221)
Enumeration Date
2020-02-27
Last Update Date
2020-07-13
Business Address
MISAGH FASAZADEH
140 S MIDDLE NECK RD APT 2E
GREAT NECK, NY 11021-3738
Phone number: 818-642-4131
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Mailing Address
MISAGH FASAZADEH
140 S MIDDLE NECK RD APT 2E
GREAT NECK, NY 11021-3738
Phone number: 818-642-4131
Copy
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