| Provider / Organization | NPI | Date Certified |
|---|---|---|
| ALI FARZAN JON | 1184035693 | 2024-09-07 |
Ali Farzan Jon [M] graduated in 2010 and primarily specializes in Diagnostic Radiology.
Ali Farzan Jon is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1184035693. Registration indicates Ali Farzan Jon is a provider of services with a specialization in Student, Health Care, Student in an Organized Health Care Education/Training Program (Student in an Organized Health Care Education/Training Program, ) (All Other Specialties & Provider Types, ) (Student in an Organized Health Care Education/Training Program, Student, Health Care) (Allopathic & Osteopathic Physicians, Radiology) (Radiology: Vascular & Interventional Radiology, ) (Diagnostics/Imaging/Laboratory/Mammography, ) (Radiology Vascular & Interventional Radiology, Allopathic & Osteopathic Physicians) (Radiology, )
| PECOS ID | 2062831936 |
| Registration | PART-B:Y DME:Y HHA:Y PMD:Y |
| Entity Type | Individual |
| Provider Name | Ali Farzan Jon MD |
| Practice Office Address | 110 LIBERTY ST BROCKTON, MA US |
| Practice Office Telephone | 5088940400 |
| Mailing Address | 680 CENTRE ST BROCKTON, MA 023023308 US |
| Business Telephone | 5089417000 |
| Code | Practice | License No State |
|---|---|---|
| 390200000X | Student, Health Care Student in an Organized Health Care Education/Training Program Student in an Organized Health Care Education/Training Program All Other Specialties & Provider Types Student in an Organized Health Care Education/Training Program Student, Health Care | |
| 2085R0204X PRIMARY | Allopathic & Osteopathic Physicians Radiology Radiology: Vascular & Interventional Radiology Diagnostics/Imaging/Laboratory/Mammography Radiology Vascular & Interventional Radiology Allopathic & Osteopathic Physicians Radiology | 284683
MA |