Provider Demographics
NPI:1780629592
Name:NANAVATI, FARZANA NILESH (MD)
Entity type:Individual
Prefix:DR
First Name:FARZANA
Middle Name:NILESH
Last Name:NANAVATI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:FARZANA
Other - Middle Name:PERVEZ
Other - Last Name:DARBARI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:85 HARRISTOWN RD STE 104
Mailing Address - Street 2:
Mailing Address - City:GLEN ROCK
Mailing Address - State:NJ
Mailing Address - Zip Code:07452-3323
Mailing Address - Country:US
Mailing Address - Phone:201-855-8300
Mailing Address - Fax:201-857-2641
Practice Address - Street 1:85 HARRISTOWN RD STE 104
Practice Address - Street 2:
Practice Address - City:GLEN ROCK
Practice Address - State:NJ
Practice Address - Zip Code:07452
Practice Address - Country:US
Practice Address - Phone:201-855-8300
Practice Address - Fax:201-857-2641
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2020-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4257792084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology