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General NPI Number Information
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NPI Number | 1962844035
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Entity Type | Individual
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Provider Name | SANA FAROOKI M.D
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Gender | Female
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Dates
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Enumeration Date | 07/18/2013
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Last Update Date | 08/03/2021
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Provider Practice Location Address
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Address Line | 830 PENNSYLVANIA AVE STE 103
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City | CHARLESTON
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State | WV
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Zip | 25302-3389
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Country | US
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Telephone | 304-388-1552
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Fax |
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Provider Business Mailing Address
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Address Line | 830 PENNSYLVANIA AVE STE 103
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City | CHARLESTON
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State | WV
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Zip | 25302-3389
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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 | 2080P0207X
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Taxonomy Name | Pediatric Hematology & Oncology Physician
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License Number | 303662
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2080P0207X
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Taxonomy Name | Pediatric Hematology & Oncology Physician
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License Number | 27565
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License Number State | WV
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 303662
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License Number State | NY
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