Provider Demographics
NPI:1073718235
Name:FAROOKI, ADIL (MD)
Entity Type:Individual
Prefix:DR
First Name:ADIL
Middle Name:
Last Name:FAROOKI
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 1:35 EVERGREEN PL
Mailing Address - Street 2:
Mailing Address - City:DEMAREST
Mailing Address - State:NJ
Mailing Address - Zip Code:07627-2441
Mailing Address - Country:US
Mailing Address - Phone:201-467-5303
Mailing Address - Fax:
Practice Address - Street 1:680 BROADWAY
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07514-1524
Practice Address - Country:US
Practice Address - Phone:973-754-0999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-18
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY256737207R00000X
NJ25MA08684400207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0298476Medicaid