Provider Demographics
NPI:1083509756
Name:FATIMA, ROOSHNA FIRDOUS (MD)
Entity type:Individual
Prefix:
First Name:ROOSHNA
Middle Name:FIRDOUS
Last Name:FATIMA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:355 BARD AVENUE
Mailing Address - Street 2:ROOM 477
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10310-1699
Mailing Address - Country:US
Mailing Address - Phone:718-818-2419
Mailing Address - Fax:718-818-3225
Practice Address - Street 1:355 BARD AVENUE
Practice Address - Street 2:ROOM 477
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10310-1699
Practice Address - Country:US
Practice Address - Phone:718-818-2419
Practice Address - Fax:718-818-3225
Is Sole Proprietor?:No
Enumeration Date:2025-06-11
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program