Provider Demographics
NPI:1720447600
Name:SYED, FERHEEN (PHYSICIAN ASSISTANT)
Entity type:Individual
Prefix:
First Name:FERHEEN
Middle Name:
Last Name:SYED
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1614 SHINING WILLOW CT
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77406-1743
Mailing Address - Country:US
Mailing Address - Phone:516-807-7847
Mailing Address - Fax:
Practice Address - Street 1:37 CREST ROAD
Practice Address - Street 2:
Practice Address - City:MANHASSET HILLS
Practice Address - State:NY
Practice Address - Zip Code:11040
Practice Address - Country:US
Practice Address - Phone:516-807-7847
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-19
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA12926363A00000X
MI5601010836363A00000X
IL085.008627363A00000X
NY019484363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant