Healthcare Provider Details

I. General information

NPI: 1629148754
Provider Name (Legal Business Name): FARINA IJAZ SIAL PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 04/14/2025
Certification Date: 04/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1097 OLD COUNTRY RD STE 105
PLAINVIEW NY
11803-6505
US

IV. Provider business mailing address

NSUH-DEPT OF NEUROSURGERY 300 COMMUNITY DRIVE
MANHASSET NY
11030
US

V. Phone/Fax

Practice location:
  • Phone: 516-423-6324
  • Fax: 949-695-2167
Mailing address:
  • Phone: 516-562-2462
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number8815
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: