Misagh Fasazadeh
Misagh Fasazadeh is a Physician Assistant in Great Neck, New York. Practices as a sole proprietor. Licensed in New York.
- Licensed in
- NY
- In the registry since
- 2020
Practice location Address checks out
140 S Middle Neck Rd Apt 2EGreat Neck, NY 11021-3738
Phone: (818) 642-4131
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Specialties & licences
| Physician Assistant (primary) | Taxonomy 363A00000X · Licence 025221 (NY) |
|---|
Record details
| NPI number | 1376177428 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | February 27, 2020 |
| Last updated in NPPES | July 13, 2020 |
| Certification date | July 13, 2020 |
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