Healthcare Provider Details

I. General information

NPI: 1801054499
Provider Name (Legal Business Name): FARHA NAQUI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2008
Last Update Date: 06/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8365A GREENSBORO DR
MC LEAN VA
22102-3530
US

IV. Provider business mailing address

8365A GREENSBORO DR
MC LEAN VA
22102-3530
US

V. Phone/Fax

Practice location:
  • Phone: 703-356-4444
  • Fax: 703-734-0129
Mailing address:
  • Phone: 703-356-4444
  • Fax: 703-734-0129

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0101248806
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: