Provider Demographics
NPI:1366408585
Name:BARODAWALA, FARIDA (MD FACA)
Entity type:Individual
Prefix:
First Name:FARIDA
Middle Name:
Last Name:BARODAWALA
Suffix:
Gender:F
Credentials:MD FACA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2333 ELMWOOD AVENUE
Mailing Address - Street 2:STE 2
Mailing Address - City:KENMORE
Mailing Address - State:NY
Mailing Address - Zip Code:14217-2646
Mailing Address - Country:US
Mailing Address - Phone:716-874-1098
Mailing Address - Fax:716-874-9616
Practice Address - Street 1:2950 ELMWOOD AVENUE
Practice Address - Street 2:KENMORE MERCY HOSPITAL
Practice Address - City:KENMORE
Practice Address - State:NY
Practice Address - Zip Code:14217
Practice Address - Country:US
Practice Address - Phone:716-447-6100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2011-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1259701207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00011177002OtherUNIVERA
NY00716569Medicaid
NY000507789001OtherBLUE CROSS
2008171OtherINDEPENDENT HEALTH
2008171OtherINDEPENDENT HEALTH
NY000507789001OtherBLUE CROSS