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GHAZANFAR W. HAIDERY MD PC
NPI 1619141645
Family Medicine in Glen Head, NY

Active since April 22, 2008CLIA 33D1006668 · Waiver
997 GLEN COVE AVE, GLEN HEAD, NY 11545(516) 676-1500(516) 759-5946 Get Directions Write a Review

NPPES record last updated: April 22, 2008. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Ghazanfar W. Haidery Md Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GHAZANFAR W. HAIDERY MD PC (NPI 1619141645) is a healthcare organization registered as a family medicine in Glen Head, New York and active in the NPI registry since April 2008. The organization holds a CLIA Waiver certificate valid through November 25, 2026 and lists Ghazanfar Wade Haidery, Owner, as its authorized official.

NPPES Registry Identity

NPI1619141645
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameGHAZANFAR W. HAIDERY MD PC
Location Address997 GLEN COVE AVEGlen Head, NY 11545-1593
Mailing Address997 Glen Cove AveGlen Head, NY 11545-1593 · (516) 676-1500 · Fax (516) 759-5946
Phone(516) 676-1500
Fax(516) 759-5946
Organization SubpartNo
Authorized OfficialGhazanfar Wade HaideryOwner · (516) 671-1500
Enumeration DateApril 22, 2008
✔ NPI 1619141645 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in NY · 210618
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
997 GLEN COVE AVE, Glen Head, NY 11545
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 33D1006668

Ghazanfar Wade Haidery MD PC · Glen Head, NY
Active · expires Nov 25, 2026
CLIA Number33D1006668
Laboratory TypePhysician Office
Certificate Effective DateNovember 26, 2024
Certificate Expiration DateNovember 25, 2026
Laboratory DirectorGhazanfar Haidery
Laboratory Phone(516) 676-1500
Laboratory LocationGhazanfar Wade Haidery MD PC997 Glen Cove Ave, Glen Head, NY 11545
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 15

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HAMED HOSSAINIAN
Nurse Practitioner (Psychiatric/Mental Health)
997 GLEN COVE AVE
GLEN HEAD, NY 11545
Nassau County (917) 499-7882
DR. THARAKARAM RAVISHANKAR MD FACE
Internal Medicine (Endocrinology, Diabetes & Metabolism)
997 GLEN COVE AVE
GLEN HEAD, NY 11545
Nassau County (516) 674-9144
MRS. CHITHKALA RAVISHANKAR MS RD CDE
Dietitian, Registered (Nutrition, Metabolic)
997 GLEN COVE AVE
GLEN HEAD, NY 11545
Nassau County (516) 674-9144
HAMED HOSSAINIAN NP IN PSYCHIATRY PLLC
Nurse Practitioner (Psychiatric/Mental Health)
997 GLEN COVE AVE
GLEN HEAD, NY 11545
Nassau County (516) 613-4622
NANCY H LARSON ANP
Nurse Practitioner (Adult Health)
997 GLEN COVE AVE
GLEN HEAD, NY 11545
Nassau County (516) 674-9144
LARISSA GOURDET A.N.P
Nurse Practitioner (Adult Health)
997 GLEN COVE AVE
GLEN HEAD, NY 11545
Nassau County (516) 674-9144
TIA TRIVISONNO L.AC
Acupuncturist
997 GLEN COVE AVE
GLEN HEAD, NY 11545
Nassau County (516) 801-1405
T.RAVISHANKAR MD PC
Internal Medicine (Endocrinology, Diabetes & Metabolism)
997 GLEN COVE AVE
GLEN HEAD, NY 11545
Nassau County (516) 674-9144

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ghazanfar W. Haidery MD PC's NPI number?

The NPI number for Ghazanfar W. Haidery MD PC is 1619141645. It was assigned to this organization in the NPPES registry on April 22, 2008.

Where is Ghazanfar W. Haidery MD PC located?

Ghazanfar W. Haidery MD PC is located at 997 Glen Cove Ave, Glen Head, NY 11545. The listed phone number is (516) 676-1500.

What is Ghazanfar W. Haidery MD PC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Ghazanfar W. Haidery MD PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 33D1006668) is associated with this NPI, valid through November 25, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Ghazanfar W. Haidery MD PC was last updated on April 22, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.