Healthcare Provider Details

I. General information

NPI: 1245144385
Provider Name (Legal Business Name): RUMAISHA FAIJA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 MEDICAL PLZ
GLEN COVE NY
11542-2108
US

IV. Provider business mailing address

100 BROADHOLLOW RD
FARMINGDALE NY
11735-4813
US

V. Phone/Fax

Practice location:
  • Phone: 516-656-8000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberP140765
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: