Healthcare Provider Details

I. General information

NPI: 1083820104
Provider Name (Legal Business Name): FARAH HUSSAIN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: FARAH FAISAL M.D.

II. Dates (important events)

Enumeration Date: 05/15/2007
Last Update Date: 05/15/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4887 STATE ROUTE 96A
ROMULUS NY
14541-9767
US

IV. Provider business mailing address

55 DUNROVIN LN
ROCHESTER NY
14618-4813
US

V. Phone/Fax

Practice location:
  • Phone: 315-585-3041
  • Fax: 315-585-3061
Mailing address:
  • Phone: 585-272-1789
  • Fax: 315-585-3061

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number270137
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: