Healthcare Provider Details

I. General information

NPI: 1164710216
Provider Name (Legal Business Name): ZEESHAN FARUQUI MBBS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2011
Last Update Date: 10/27/2023
Certification Date: 10/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 CHAMBERS HILL DR STE 200
CHAMBERSBURG PA
17201-7301
US

IV. Provider business mailing address

111 CHAMBERS HILL DR STE 200
CHAMBERSBURG PA
17201-7304
US

V. Phone/Fax

Practice location:
  • Phone: 717-709-7930
  • Fax: 717-709-7931
Mailing address:
  • Phone: 717-709-7922
  • Fax: 717-263-2055

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number26344
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number0101257295
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD464411
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: