Search › New York › 363A00000X
Misagh Fasazadeh
NPI 1376177428 · on the registry since 2020 · sole proprietor
Practice
- Address
- 140 S Middle Neck Rd Apt 2e
Great Neck, NY 11021 - Phone
- (818) 642-4131
Registry record
- Primary taxonomy
- 363A00000X
363A00000X
- Licence states on file
- NY
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2020-07-13
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in New York