Darice Williams Fadeyi, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

234479 Issued in NY

Practice address

245 5TH Ave FL 3
New York, NY 10016-8728

Phone

(929) 213-7785

NPI assigned

Aug 24, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Fadeyi Dermatology PLLC

  • Dermatology Physician
  • New York, NY
  • NPI 1679151997
  NPD Authorized official

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

{
    "created_epoch": "1251072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618185600000",
    "number": "1427280544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 PARK AVE",
            "address_2": "SUITE 1940",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100161341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 5TH AVE FL 3",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100168728",
            "telephone_number": "929-213-7785"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "336 Route 202 Ste D",
            "address_purpose": "LOCATION",
            "city": "Somers",
            "state": "NY",
            "postal_code": "105893220",
            "country_code": "US",
            "telephone_number": "914-617-8950",
            "fax_number": "914-617-8960",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "121 Avenue Of The Americas",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "10013",
            "country_code": "US",
            "telephone_number": "212-453-0201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FADEYI",
        "first_name": "DARICE",
        "middle_name": "WILLIAMS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-24",
        "last_updated": "2021-04-12",
        "certification_date": "2021-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "234479",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04916652",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jonathan Fader, PHD
• Ralph Parker Fader IV, M.D.
• Sharon Rebecca Fader, LCSW
• Thelma Villar Faderan
• Fadeyi Dermatology PLLC
• Jason Toyin Fadeyi, M.D.
• Fadi F. Attiyeh, M.D., P.C.
• Akintayo Olalekan Fadoju, RN, NP
• Brendaliz Fadul, MHC
• Debra Sue Faecher, LCSW

• Dermatology Physician in New York, NY
• Providers in New York, NY by specialty
• Dermatology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2021; 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.