Healthcare Provider Details

I. General information

NPI: 1083023683
Provider Name (Legal Business Name): MUHAMMAD UMER FAROOQ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2014
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 FRANCIS ST
BOSTON MA
02115-6106
US

IV. Provider business mailing address

1825 EASTCHESTER RD
BRONX NY
10461-2301
US

V. Phone/Fax

Practice location:
  • Phone: 617-732-7144
  • Fax:
Mailing address:
  • Phone: 718-904-2500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number1027278
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: