Provider Demographics
NPI:1437855111
Name:FAYED, ESRAA M
Entity Type:Individual
Prefix:DR
First Name:ESRAA
Middle Name:M
Last Name:FAYED
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 OVINGTON AVE APT 5C
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-1489
Mailing Address - Country:US
Mailing Address - Phone:934-300-1226
Mailing Address - Fax:
Practice Address - Street 1:345 OVINGTON AVE APT 5C
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-1489
Practice Address - Country:US
Practice Address - Phone:934-300-1226
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-03
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty