MEDICARE: F FAROOQI DNP, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center
2	2084P0804X	Child & Adolescent Psychiatry Physician

General Provider Information

NPI Number	:	1346027547
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	F FAROOQI DNP, LLC

Provider Business Mailing Address
First Line	:	477 MINE BROOK RD
Second Line	:
City	:	BERNARDSVILLE
State	:	NJ
Zip	:	07924-2007
Country	:	US
Telephone Number	:	201-744-1391
Fax Number	:	908-502-5791

Provider Business Practice Location Address
First Line	:	477 MINE BROOK RD
Second Line	:
City	:	BERNARDSVILLE
State	:	NJ
Zip	:	07924-2007
Country	:	US
Telephone Number	:	551-275-5674
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	FARKHANDA FAROOQI
Credential	:	NP
Telephone Number	:	201-744-1391

Provider Enumeration Date	:	09/11/2023
Last Update Date	:	04/23/2024

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