Active NPI
Fariya Islam
- Dentist
- New Hyde Park, NY
National Provider Identifier
1609376722
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 060580
- Practice address
- 27005 76TH Ave
New Hyde Park, NY 11040-1402 - Phone
- (718) 470-7120
- Fax
- (718) 470-7120
- NPI assigned
- Feb 15, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 060580 | NY | Primary |
Addresses
Primary practice location
27005 76TH Ave
New Hyde Park, NY 11040-1402
Mailing address
27005 76TH Ave
New Hyde Park, NY 11040-1402
Phone (718) 470-7120
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190103000620 | NY | Order and Referring Only - Dentist | 6901141472 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 060580 | NY | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1518652800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1579651200000",
"number": "1609376722",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "27005 76TH AVE",
"city": "NEW HYDE PARK",
"state": "NY",
"postal_code": "110401402",
"telephone_number": "718-470-7120"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "27005 76TH AVE",
"city": "NEW HYDE PARK",
"state": "NY",
"postal_code": "110401402",
"telephone_number": "718-470-7120",
"fax_number": "718-470-7120"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ISLAM",
"first_name": "FARIYA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-02-15",
"last_updated": "2020-01-22",
"certification_date": "2020-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "060580",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Hyde Park, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.