Provider Demographics
NPI:1740177757
Name:HASANI, FARID
Entity type:Individual
Prefix:
First Name:FARID
Middle Name:
Last Name:HASANI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 ENTERPRISE DR STE B
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040-1606
Mailing Address - Country:US
Mailing Address - Phone:732-682-4651
Mailing Address - Fax:
Practice Address - Street 1:125 ENTERPRISE DR STE B
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-1606
Practice Address - Country:US
Practice Address - Phone:732-682-4651
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-23
Last Update Date:2025-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies