Farhana Mansoob, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

238665-1 Issued in NY

Practice address

South Shore Association for Independent Living, Inc.
1976 Grand Avenue
Baldwin, NY 11510

Phone

(516) 855-1800

Fax

(516) 855-1811

NPI assigned

Dec 26, 2007

Last updated

Dec 17, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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

• South Shore Asociation for Independent Living, Inc.

  • Counselor
  • Baldwin, NY
  • NPI 1174733539
  NPD (past)

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

{
    "created_epoch": "1198627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576540800000",
    "number": "1780868885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "SOUTH SHORE ASSOCIATION FOR INDEPENDENT LIVING, INC.",
            "address_2": "1976 GRAND AVENUE",
            "city": "BALDWIN",
            "state": "NY",
            "postal_code": "11510",
            "telephone_number": "516-855-1800",
            "fax_number": "516-855-1811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SOUTH SHORE ASSOCIATION FOR INDEPENDENT LIVING, INC.",
            "address_2": "1976 GRAND AVENUE",
            "city": "BALDWIN",
            "state": "NY",
            "postal_code": "11510",
            "telephone_number": "516-855-1800",
            "fax_number": "516-855-1811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANSOOB",
        "first_name": "FARHANA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-26",
        "last_updated": "2019-12-17",
        "certification_date": "2019-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "238665-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dominique R Magloire-Gattereau, LPN
• Deborah Lynn Magnus-Williams
• Angela D Mahler-Romeo, LMSW CSW
• Tyquanna Mangum-Lutchmansingh
• Jasmine Manning
• Amanda Rose Marcos, M.A., CCC SLP
• Andrew Marcos, PAC
• Gigi G Mardigras, M.S.ED.
• Caron Margolin, M.S., C.C.C.-SLP
• Steffany Lissette Martinez

• Psychiatry Physician in Baldwin, NY
• Providers in Baldwin, NY by specialty
• Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2019; 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.

Verify at the official NPI Registry.