Provider Demographics
NPI:1992876346
Name:FARIDI, NUZHAT (MD)
Entity type:Individual
Prefix:
First Name:NUZHAT
Middle Name:
Last Name:FARIDI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NUZHAT
Other - Middle Name:
Other - Last Name:FARIDI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:671 COLLEGE ROAD
Mailing Address - Street 2:
Mailing Address - City:FARMINGVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11738
Mailing Address - Country:US
Mailing Address - Phone:718-426-1000
Mailing Address - Fax:718-426-1100
Practice Address - Street 1:37 58 72ND ST
Practice Address - Street 2:
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372
Practice Address - Country:US
Practice Address - Phone:718-426-1000
Practice Address - Fax:718-426-1100
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY197647207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02139559Medicaid
G53326Medicare UPIN
NY02139559Medicaid