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General NPI Number Information
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NPI Number | 1760125827
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Entity Type | Individual
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Provider Name | BEENISH FARAZ DO
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Gender | Female
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Dates
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Enumeration Date | 04/18/2022
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Last Update Date | 09/23/2025
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Provider Practice Location Address
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Address Line | 4940 EASTERN AVE
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City | BALTIMORE
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State | MD
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Zip | 21224-2735
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Country | US
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Telephone | 571-344-1045
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Fax |
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Provider Business Mailing Address
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Address Line | 4940 EASTERN AVE
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City | BALTIMORE
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State | MD
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Zip | 21224-2735
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Country | US
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Telephone |
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 0116036785
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | H0104726
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License Number State | MD
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