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Individual

MINA FARID

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
12 YUCCA DR, STATEN ISLAND, NY 10312-1634
(646) 251-8337
Mailing address
302 N WASHINGTON AVE STE W102, MOORESTOWN, NJ 08057-2450
(856) 222-3445

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
060874-01
NY
122300000X
Dentist
Primary
22DI02757400
NJ
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
03/31/2018
Last updated
10/27/2023
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