Healthcare Provider Details

I. General information

NPI: 1265617138
Provider Name (Legal Business Name): BURHANUDDIN M FAROOQI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2008
Last Update Date: 04/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

605 S GEORGE ST SUITE 200
YORK PA
17401-3160
US

IV. Provider business mailing address

3421 CONCORD RD
YORK PA
17402-9001
US

V. Phone/Fax

Practice location:
  • Phone: 717-851-3498
  • Fax: 717-851-3498
Mailing address:
  • Phone: 717-851-2334
  • Fax: 717-851-3498

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD444698
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: