MEDICARE: FARZANA MATIN, M.D., P.C.

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	207R00000X	Internal Medicine Physician	258280	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1699280453
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FARZANA MATIN, M.D., P.C.

Provider Business Mailing Address
First Line	:	15 HILTON AVE
Second Line	:
City	:	GARDEN CITY
State	:	NY
Zip	:	11530-4400
Country	:	US
Telephone Number	:	917-405-1517
Fax Number	:

Provider Business Practice Location Address
First Line	:	4024 76TH ST STE 1AB
Second Line	:
City	:	ELMHURST
State	:	NY
Zip	:	11373-1009
Country	:	US
Telephone Number	:	718-844-6302
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR/CEO
Name	:	FARZANA MATIN
Credential	:	MD
Telephone Number	:	917-405-1517

Provider Enumeration Date	:	12/01/2017
Last Update Date	:	09/30/2023

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