Active NPI
Farhad Haeri, PT DPT
- Physical Therapist
- Huntington, NY
National Provider Identifier
1174593685
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 0155911
- Practice address
- 775 Park Ave
Suite #200-12
Huntington, NY 11743 - Phone
- (631) 385-0066
- Fax
- (631) 385-0770
- NPI assigned
- Jan 25, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 0155911 | NY | Primary |
Addresses
Primary practice location
775 Park Ave
Suite #200-12
Huntington, NY 11743
Mailing address
1035 Westminster Ave
Dix Hills, NY 11746
Phone (631) 385-0066
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02019134 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0155911 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138147200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1355702400000",
"number": "1174593685",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1035 WESTMINSTER AVE",
"city": "DIX HILLS",
"state": "NY",
"postal_code": "11746",
"telephone_number": "631-385-0066",
"fax_number": "631-385-0770"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "775 PARK AVE",
"address_2": "SUITE #200-12",
"city": "HUNTINGTON",
"state": "NY",
"postal_code": "11743",
"telephone_number": "631-385-0066",
"fax_number": "631-385-0770"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAERI",
"first_name": "FARHAD",
"name_prefix": "Dr.",
"credential": "PT DPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-01-25",
"last_updated": "2012-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "0155911",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02019134",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Huntington, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.