Provider Demographics
NPI:1699098954
Name:FAROOQUI, WASIM (RPH)
Entity type:Individual
Prefix:
First Name:WASIM
Middle Name:
Last Name:FAROOQUI
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MRS
Other - First Name:WASIM
Other - Middle Name:FAROOQUI
Other - Last Name:TAHIR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:1107 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PEEKSKILL
Mailing Address - State:NY
Mailing Address - Zip Code:10566-2907
Mailing Address - Country:US
Mailing Address - Phone:914-737-0154
Mailing Address - Fax:914-788-7037
Practice Address - Street 1:108 HITCHING POST LN
Practice Address - Street 2:
Practice Address - City:YORKTOWN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:10598-2833
Practice Address - Country:US
Practice Address - Phone:914-455-2595
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-01
Last Update Date:2015-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY46600183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist