Basic Information
Provider Information
NPI: 1982703302
EntityType: 2
ReplacementNPI:  
OrganizationName: FARZANA HABIB
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: NEWFANE OB-GYN
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2590 WILLIAM ST
Address2:  
City: NEWFANE
State: NY
PostalCode: 141081026
CountryCode: US
TelephoneNumber: 7166923302
FaxNumber: 7166924342
Practice Location
Address1: 2590 WILLIAM ST
Address2:  
City: NEWFANE
State: NY
PostalCode: 141081026
CountryCode: US
TelephoneNumber: 7167786240
FaxNumber: 7166924342
Other Information
ProviderEnumerationDate: 09/22/2006
LastUpdateDate: 08/22/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: HABIB
AuthorizedOfficialFirstName: FARZANA
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: OWNER
AuthorizedOfficialTelephone: 7167736240
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: MD
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000X239667NYY193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansObstetrics & Gynecology 

No ID Information.


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