Provider Demographics
NPI:1164769378
Name:FARID, RANGELYN M (RN)
Entity Type:Individual
Prefix:
First Name:RANGELYN
Middle Name:M
Last Name:FARID
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 HARRIETT ST
Mailing Address - Street 2:
Mailing Address - City:WANAQUE
Mailing Address - State:NJ
Mailing Address - Zip Code:07465-2219
Mailing Address - Country:US
Mailing Address - Phone:862-228-2207
Mailing Address - Fax:
Practice Address - Street 1:114 HARRIET STREET
Practice Address - Street 2:
Practice Address - City:WANAQUE
Practice Address - State:NJ
Practice Address - Zip Code:07465-2119
Practice Address - Country:US
Practice Address - Phone:862-228-2207
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-08
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR10477800163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse