Provider Demographics
NPI:1821310194
Name:ZIAUDDIN, FAAIZA
Entity Type:Individual
Prefix:MRS
First Name:FAAIZA
Middle Name:
Last Name:ZIAUDDIN
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 1:1080 WESTMINSTER AVE
Mailing Address - Street 2:
Mailing Address - City:DIX HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11746-6336
Mailing Address - Country:US
Mailing Address - Phone:631-595-2888
Mailing Address - Fax:
Practice Address - Street 1:1080 WESTMINSTER AVE
Practice Address - Street 2:
Practice Address - City:DIX HILLS
Practice Address - State:NY
Practice Address - Zip Code:11746-6336
Practice Address - Country:US
Practice Address - Phone:631-595-2888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-26
Last Update Date:2010-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY046945183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist