MEDICARE: FAROOQ HABIB MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	202930	NY

General Provider Information

NPI Number	:	1760582373
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FAROOQ HABIB MD

Provider Business Mailing Address
First Line	:	309 FABRY TER
Second Line	:
City	:	TEANECK
State	:	NJ
Zip	:	07666-6472
Country	:	US
Telephone Number	:	201-679-8979
Fax Number	:

Provider Business Practice Location Address
First Line	:	1675 WESTCHESTER AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10472-3001
Country	:	US
Telephone Number	:	718-842-0900
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/24/2006
Last Update Date	:	07/08/2007

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