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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MISAGH FASAZADEH

Active Sole Proprietor

MISAGH FASAZADEH is a Physician Assistant healthcare provider located in GREAT NECK, New York. NPI 1376177428 is currently active in the NPPES registry. Verify at CMS.

Physician Assistant · GREAT NECK, NY

Registration Details

NPI Number
1376177428
Provider Type
Individual
Gender
Male
NPI Issued
Feb 27, 2020 (6.4192671552656 yrs)
Last Updated
Jul 13, 2020
License
025221 (NY)
Sole Proprietor
Yes

Practice Information

Address
140 S MIDDLE NECK RD APT 2E
GREAT NECK, NY, 110213738
Browse NY providers · Browse ZIP 11021
Phone
8186424131
Primary Specialty
Physician Assistant
363A00000X

Other Physician Assistant Providers in GREAT NECK, NY

Name Credential NPI
MRS. MARY ELIZABETH OGRADY RPAC 1154497675
KENNETH STROBEL P.A. 1508992421
EVELINA BADALOV PA 1689704967
MARY ELLEN CASSIDY PA 1114101615
GHAZALEH YASMEH 1053576660
MS. LAUREN TAYLOR TEDESCO P.A. 1972769578
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.