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General NPI Number Information
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NPI Number | 1275396582
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Entity Type | Individual
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Provider Name | FARDIN AKBAR HYDERI
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Gender | Male
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Dates
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Enumeration Date | 01/31/2024
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Last Update Date | 01/31/2024
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Provider Practice Location Address
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Address Line | 70 E SUNRISE HWY STE 605
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City | VALLEY STREAM
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State | NY
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Zip | 11581-1233
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Country | US
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Telephone | 718-295-6000
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Fax |
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Provider Business Mailing Address
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Address Line | 14021 173RD ST
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City | JAMAICA
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State | NY
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Zip | 11434-4625
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Country | US
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Telephone | 646-886-5971
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number | P125309
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License Number State | NY
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