1134387467 NPI number — DR. FARIDA PARVEEN DDS

Table of content: DR. FARIDA PARVEEN DDS (NPI 1134387467)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134387467 NPI number — DR. FARIDA PARVEEN DDS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PARVEEN
Provider First Name:
FARIDA
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DDS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1134387467
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/22/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2002 MCGRAW AVE
Provider Second Line Business Mailing Address:
1ST FLOOR
Provider Business Mailing Address City Name:
BRONX
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10462-8009
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-239-8250
Provider Business Mailing Address Fax Number:
718-239-7659

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2002 MCGRAW AVE
Provider Second Line Business Practice Location Address:
1ST FLOOR
Provider Business Practice Location Address City Name:
BRONX
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10462-8009
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-239-8250
Provider Business Practice Location Address Fax Number:
718-239-7659
Provider Enumeration Date:
05/22/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  051518 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 02582676 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 9185369 . This is a "DORAL DENTAL" identifier , issued by the state of ( WI ) . This identifiers is of the category "OTHER".