Individual provider Active NPI

Fariba Delafraz

  • Case Manager/Care Coordinator
  • Plainview, NY
National Provider Identifier
1245606052
Registry record updated Aug 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
License
605512693 Issued in NY
Practice address
255 Executive Dr
Plainview, NY 11803-1718
Phone
(516) 576-2040
NPI assigned
Aug 16, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 16, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X 605512693 NY Primary

Addresses

Primary practice location

255 Executive Dr
Plainview, NY 11803-1718

Mailing address

5 South St
Great Neck, NY 11023-1218
Phone (516) 655-5960

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
605512693NYMDCase Manager/Care Coordinator

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1439683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439683200000",
    "number": "1245606052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 SOUTH ST",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110231218",
            "telephone_number": "516-655-5960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 EXECUTIVE DR",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "118031718",
            "telephone_number": "516-576-2040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELAFRAZ",
        "first_name": "FARIBA",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-16",
        "last_updated": "2015-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NY",
            "license": "605512693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plainview, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.