Provider Demographics
NPI:1194132639
Name:DURRANI, FARIDA (MD)
Entity type:Individual
Prefix:
First Name:FARIDA
Middle Name:
Last Name:DURRANI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1288 BAY ST
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10305-3123
Mailing Address - Country:US
Mailing Address - Phone:501-940-8067
Mailing Address - Fax:
Practice Address - Street 1:2601 OCEAN PARKWAY
Practice Address - Street 2:CONEY ISLAND HOSPITAL DEPARTMENT OF PATHOLODY
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235
Practice Address - Country:US
Practice Address - Phone:718-616-3000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-16
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY282N00000X
291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
No282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY$$$$$$$$$-AMedicaid