Individual
DR. FARIDA GHADIALI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
SULLIVAN WAY, WEST TRENTON, NJ 08628
(609) 633-1502
(609) 777-4095
Mailing address
6 WALNUT HOLLOW LN, HOLMDEL, NJ 07733-1352
(609) 633-2048
(609) 777-4094
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MA037322
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
717296C2D
'MEDICARE BILLING NO'
NJ
Enumeration date
10/10/2006
Last updated
12/19/2007
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