Provider Demographics
NPI:1679108674
Name:SIDDIQUI, FERRIZA (RN, MSN, FNP-BC)
Entity Type:Individual
Prefix:MS
First Name:FERRIZA
Middle Name:
Last Name:SIDDIQUI
Suffix:
Gender:F
Credentials:RN, MSN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:89-00 170TH STREET
Mailing Address - Street 2:APT 5P
Mailing Address - City:JAMAICA, QUEENS
Mailing Address - State:NY
Mailing Address - Zip Code:11432
Mailing Address - Country:US
Mailing Address - Phone:917-683-3112
Mailing Address - Fax:
Practice Address - Street 1:410 LAKEVILLE RD STE 206
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11042-1122
Practice Address - Country:US
Practice Address - Phone:718-470-7644
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-10
Last Update Date:2020-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY345178363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily