Provider Demographics
NPI:1538233358
Name:FAROOQUI, SYEDA SALEHA (MD)
Entity type:Individual
Prefix:
First Name:SYEDA
Middle Name:SALEHA
Last Name:FAROOQUI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 CURLEY CT
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-1632
Mailing Address - Country:US
Mailing Address - Phone:201-982-3605
Mailing Address - Fax:
Practice Address - Street 1:26-01 26TH STREET
Practice Address - Street 2:STE 105
Practice Address - City:FAIR LAWN
Practice Address - State:NJ
Practice Address - Zip Code:07410
Practice Address - Country:US
Practice Address - Phone:201-703-3664
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07605000207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0008770Medicaid
NJ0008770Medicaid
NJF91537Medicare UPIN