Provider Demographics
NPI:1699783324
Name:BERENJI, FARID (MD)
Entity type:Individual
Prefix:DR
First Name:FARID
Middle Name:
Last Name:BERENJI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:908 NIAGARA FALLS BLVD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:NORTH TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14120-2019
Mailing Address - Country:US
Mailing Address - Phone:716-692-2160
Mailing Address - Fax:716-692-4342
Practice Address - Street 1:3085 HARLEM RD
Practice Address - Street 2:SUITE 300
Practice Address - City:CHEEKTOWAGA
Practice Address - State:NY
Practice Address - Zip Code:14225-2591
Practice Address - Country:US
Practice Address - Phone:716-422-5422
Practice Address - Fax:716-422-5420
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2017-04-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY2327461207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02589164Medicaid
NY02589164Medicaid