Healthcare Provider Details

I. General information

NPI: 1740630086
Provider Name (Legal Business Name): FAIZUN NAHAR NNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2016
Last Update Date: 02/26/2025
Certification Date: 02/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

736 IRVING AVE
SYRACUSE NY
13210-1602
US

IV. Provider business mailing address

8215 BRITTON AVE APT 1C
ELMHURST NY
11373-2468
US

V. Phone/Fax

Practice location:
  • Phone: 347-257-3239
  • Fax:
Mailing address:
  • Phone: 347-257-3239
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License Number350581
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License Number26NJ15118900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: