Provider Demographics
NPI:1124131560
Name:ABIDI, SYED ASRAR
Entity type:Individual
Prefix:
First Name:SYED
Middle Name:ASRAR
Last Name:ABIDI
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 1:10 JAEGGER DRIVE
Mailing Address - Street 2:
Mailing Address - City:GLEN HEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11545
Mailing Address - Country:US
Mailing Address - Phone:516-671-0109
Mailing Address - Fax:516-671-0126
Practice Address - Street 1:300 GARDEN CITY PLAZA
Practice Address - Street 2:SUITE 324
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530
Practice Address - Country:US
Practice Address - Phone:516-294-9088
Practice Address - Fax:516-294-9087
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYNY2044472084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01735937Medicaid
NY01735937Medicaid
NY53M191Medicare ID - Type Unspecified