Provider Demographics
NPI:1235104662
Name:FARACI, NICK GERALD (MD)
Entity Type:Individual
Prefix:DR
First Name:NICK
Middle Name:GERALD
Last Name:FARACI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4982 HYLAN BLVD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10312-6399
Mailing Address - Country:US
Mailing Address - Phone:718-967-6200
Mailing Address - Fax:718-967-6314
Practice Address - Street 1:1407 W 6TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11204-4802
Practice Address - Country:US
Practice Address - Phone:718-256-1052
Practice Address - Fax:718-256-4912
Is Sole Proprietor?:No
Enumeration Date:2006-02-20
Last Update Date:2014-07-30
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Provider Licenses
StateLicense IDTaxonomies
NY159197208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics