Provider Demographics
NPI:1649759143
Name:MAHMUD-SYED, FARIHA N
Entity Type:Individual
Prefix:MS
First Name:FARIHA
Middle Name:N
Last Name:MAHMUD-SYED
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 1:15211 89TH AVE APT 1523
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-4935
Mailing Address - Country:US
Mailing Address - Phone:929-920-7598
Mailing Address - Fax:
Practice Address - Street 1:8114 QUEENS BLVD
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-3789
Practice Address - Country:US
Practice Address - Phone:718-889-9810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-07
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106H00000X
NY001757-01106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist