Provider Demographics
NPI:1821008293
Name:HABIB, FARZANA (MD)
Entity Type:Individual
Prefix:
First Name:FARZANA
Middle Name:
Last Name:HABIB
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 1:646 N FRENCH RD STE 1
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14228-2100
Mailing Address - Country:US
Mailing Address - Phone:716-568-2155
Mailing Address - Fax:716-434-4267
Practice Address - Street 1:646 N FRENCH RD STE 1
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14228-2100
Practice Address - Country:US
Practice Address - Phone:716-568-2155
Practice Address - Fax:716-434-4267
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2014-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY239667207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYIA1061Medicare PIN