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General NPI Number Information
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NPI Number | 1578439907
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Entity Type | Individual
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Provider Name | WALAA FARAG
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Gender | Female
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Dates
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Enumeration Date | 10/14/2025
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Last Update Date | 10/14/2025
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Provider Practice Location Address
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Address Line | 54 E HIGH ST
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City | EAST HAMPTON
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State | CT
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Zip | 06424-1052
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Country | US
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Telephone | 860-267-6853
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Fax |
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Provider Business Mailing Address
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Address Line | 9 HUNTINGTON DR
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City | MOODUS
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State | CT
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Zip | 06469-1252
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Country | US
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Telephone | 551-221-5437
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Fax |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 0017245
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License Number State | CT
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