Provider Demographics
NPI:1598076705
Name:FAROOQUI, ALI A (MD)
Entity type:Individual
Prefix:DR
First Name:ALI
Middle Name:A
Last Name:FAROOQUI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8003 LYNDON CENTRE WAY STE 202
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40222-3604
Mailing Address - Country:US
Mailing Address - Phone:502-327-7701
Mailing Address - Fax:502-327-7705
Practice Address - Street 1:8003 LYNDON CENTRE WAY STE 202
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40222-3604
Practice Address - Country:US
Practice Address - Phone:502-327-7701
Practice Address - Fax:502-327-7705
Is Sole Proprietor?:No
Enumeration Date:2010-06-23
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010020458207T00000X
KY51657390200000X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program