Healthcare Provider Details

I. General information

NPI: 1396909107
Provider Name (Legal Business Name): FIROZA ZAMAN FARUQUI D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2008
Last Update Date: 06/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8245 NORTHCREEK DR
CINCINNATI OH
45236-2283
US

IV. Provider business mailing address

4685 FOREST AVE STE C
CINCINNATI OH
45212-3359
US

V. Phone/Fax

Practice location:
  • Phone: 513-246-7000
  • Fax: 513-246-5284
Mailing address:
  • Phone: 513-246-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number34.011631
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: