MEDICARE: FARIDA E FARRAG

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	101YM0800X	Mental Health Counselor	P129599	NY

General Provider Information

NPI Number	:	1316817737
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FARIDA E FARRAG

Provider Business Mailing Address
First Line	:	358 TULIP AVE
Second Line	:
City	:	FLORAL PARK
State	:	NY
Zip	:	11001-2837
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	442 LORIMER ST STE D
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11206-1030
Country	:	US
Telephone Number	:	917-600-5461
Fax Number	:

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

Provider Enumeration Date	:	11/10/2025
Last Update Date	:	11/19/2025

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Directions to “ FARIDA E FARRAG ” Practice Location

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