Provider Demographics
NPI:1902101942
Name:NENTIN, FARIDA G (MD)
Entity Type:Individual
Prefix:DR
First Name:FARIDA
Middle Name:G
Last Name:NENTIN
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 1:1176 5TH AVE
Mailing Address - Street 2:9TH FLOOR, BOX 1170
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-6503
Mailing Address - Country:US
Mailing Address - Phone:212-241-9791
Mailing Address - Fax:
Practice Address - Street 1:1176 5TH AVE
Practice Address - Street 2:9TH FLOOR, BOX 1170
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6503
Practice Address - Country:US
Practice Address - Phone:212-241-9791
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-24
Last Update Date:2016-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY253958-1207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology