Misagh Fasazadeh Valid NPI

Individual provider · Physician Assistant · Great Neck, NY

NPI

1376177428

Type

Individual (Type 1)

Primary specialty

Physician Assistant

Specialty group

Physician Assistants & Advanced Practice Nursing Providers

Taxonomy code

363A00000X

License number

025221 (NY)

Sex

Male

Sole proprietor

Yes

Enumerated

2020-02-27

Last updated

2020-07-13