Provider Demographics
NPI:1558341206
Name:VIDAL-FARINO, ZORAYDA (MD)
Entity Type:Individual
Prefix:DR
First Name:ZORAYDA
Middle Name:
Last Name:VIDAL-FARINO
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 1:60 GRANITE ST
Mailing Address - Street 2:
Mailing Address - City:LYNN
Mailing Address - State:MA
Mailing Address - Zip Code:01904-2915
Mailing Address - Country:US
Mailing Address - Phone:781-599-9200
Mailing Address - Fax:781-477-6967
Practice Address - Street 1:60 GRANITE ST
Practice Address - Street 2:BAYRIDGE HOSPITAL
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01904-2915
Practice Address - Country:US
Practice Address - Phone:781-599-9200
Practice Address - Fax:781-477-6906
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2018-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1541712084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ25967OtherBCBS
MA110034253AOtherMASS HEALTH
MAH79602Medicare UPIN
A35069Medicare ID - Type Unspecified