Basic Information
| Provider Information | |||||||||
| NPI: | 1194193276 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HAROUN | ||||||||
| FirstName: | FARIDA | ||||||||
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| Credential: | PT,DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 31 NEW DORP LN | ||||||||
| Address2: | |||||||||
| City: | STATEN ISLAND | ||||||||
| State: | NY | ||||||||
| PostalCode: | 103062351 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7188445350 | ||||||||
| FaxNumber: | 7183900067 | ||||||||
| Practice Location | |||||||||
| Address1: | 1715 AVENUE T | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112293404 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7183368206 | ||||||||
| FaxNumber: | 7183368209 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/08/2015 | ||||||||
| LastUpdateDate: | 09/08/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 039038 | NY | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.