Provider Demographics
NPI:1093552176
Name:MAHBOOB, FARIHA (MD)
Entity type:Individual
Prefix:
First Name:FARIHA
Middle Name:
Last Name:MAHBOOB
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 WESTMINSTER CT
Mailing Address - Street 2:
Mailing Address - City:COLLEGEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19426-4423
Mailing Address - Country:US
Mailing Address - Phone:191-356-8377
Mailing Address - Fax:
Practice Address - Street 1:THE GRAND REHABILITATION AND NURSING HOME AT BARNWELL
Practice Address - Street 2:
Practice Address - City:3230 CHURCH ST, VALATIE
Practice Address - State:NY
Practice Address - Zip Code:12184
Practice Address - Country:US
Practice Address - Phone:855-999-4938
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-15
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY129039207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine