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General NPI Number Information
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NPI Number | 1356798227
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Entity Type | Individual
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Provider Name | FARAH HAKIM
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Gender | Female
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Dates
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Enumeration Date | 05/19/2016
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Last Update Date | 07/21/2016
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Provider Practice Location Address
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Address Line | 290 TURNPIKE RD STE 150-414
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City | WESTBOROUGH
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State | MA
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Zip | 01581-2843
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Country | US
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Telephone | 774-535-9641
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Fax | 617-716-5572
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Provider Business Mailing Address
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Address Line | EASTERN MEDICAL ASSOCIATES, LLC SUITE 150-414
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City | WESTBOROUGH
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State | MA
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Zip | 01581
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Country | US
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Telephone | 774-535-9641
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Fax | 617-716-5572
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA5654
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License Number State | MA
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