Provider Demographics
NPI:1538152814
Name:FAROOQ, JOSEPH (MD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:FAROOQ
Suffix:
Gender:M
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:PO BOX 14890
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12212-4890
Mailing Address - Country:US
Mailing Address - Phone:518-525-5634
Mailing Address - Fax:518-649-4094
Practice Address - Street 1:2 NEW HAMPSHIRE AVE
Practice Address - Street 2:STE250
Practice Address - City:TROY
Practice Address - State:NY
Practice Address - Zip Code:12180-1753
Practice Address - Country:US
Practice Address - Phone:518-272-0331
Practice Address - Fax:518-271-9007
Is Sole Proprietor?:No
Enumeration Date:2005-08-23
Last Update Date:2021-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY184548-1207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01593599Medicaid
E86398Medicare UPIN
NY37806KMedicare ID - Type Unspecified