MEDICARE: FARAH NAZ PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2081P2900X	Pain Medicine (Physical Medicine & Rehabilitation) Physician	055871	NY

General Provider Information

NPI Number	:	1184554073
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FARAH NAZ PT

Provider Business Mailing Address
First Line	:	1835 RICHMOND RD
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10306-2560
Country	:	US
Telephone Number	:	718-502-5271
Fax Number	:	347-857-6005

Provider Business Practice Location Address
First Line	:	1835 RICHMOND RD
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10306-2560
Country	:	US
Telephone Number	:	718-502-5271
Fax Number	:	347-857-6005

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/21/2026
Last Update Date	:	05/21/2026

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