MEDICARE: DR. FAIZ EHSAN NIAZ MD

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	2084N0400X	Neurology Physician	31032	TN
2	2084N0400X	Neurology Physician	25IA12904000	NJ

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1922058023
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FAIZ EHSAN NIAZ MD

Provider Business Mailing Address
First Line	:	331 NEWMAN SPRINGS ROAD
Second Line	:	BLDG. 2, SUITE 220
City	:	RED BANK
State	:	NJ
Zip	:	07701
Country	:	US
Telephone Number	:	732-807-0877
Fax Number	:	201-751-1680

Provider Business Practice Location Address
First Line	:	245 RIVER PARK NORTH DR
Second Line	:
City	:	WOODSTOCK
State	:	GA
Zip	:	30188-7835
Country	:	US
Telephone Number	:	770-345-0070
Fax Number	:	770-345-0077

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

Provider Enumeration Date	:	05/11/2006
Last Update Date	:	12/04/2025

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Directions to “ DR. FAIZ EHSAN NIAZ MD” Practice Location

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