Provider Demographics
NPI:1194903203
Name:ROOMI, FARAH (MD)
Entity type:Individual
Prefix:
First Name:FARAH
Middle Name:
Last Name:ROOMI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:FARAH
Other - Middle Name:
Other - Last Name:HUSSAIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1038 E CHESTNUT AVE
Mailing Address - Street 2:
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08360-5800
Mailing Address - Country:US
Mailing Address - Phone:856-691-3300
Mailing Address - Fax:856-794-7184
Practice Address - Street 1:105 MANHEIM AVE
Practice Address - Street 2:
Practice Address - City:BRIDGETON
Practice Address - State:NJ
Practice Address - Zip Code:08302-2139
Practice Address - Country:US
Practice Address - Phone:856-451-4700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-31
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08242800207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0171611Medicaid
D09077900OtherCDS REGISTRATION NUMBER
NJFR0529389OtherDEA