Provider Demographics
NPI:1285814731
Name:RASSIWALA, FARIDA ZAKIR (MD)
Entity Type:Individual
Prefix:DR
First Name:FARIDA
Middle Name:ZAKIR
Last Name:RASSIWALA
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 1:3885 S VAL VISTA DR
Mailing Address - Street 2:SUITE #103
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85297-7313
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3885 S VAL VISTA DR
Practice Address - Street 2:SUITE #103
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85297-7313
Practice Address - Country:US
Practice Address - Phone:917-968-9357
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-13
Last Update Date:2013-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ444622084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry