Provider Demographics
NPI:1194021287
Name:FAROOQ, NADIA (MS)
Entity Type:Individual
Prefix:
First Name:NADIA
Middle Name:
Last Name:FAROOQ
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 CHRISTOPHER COLUMBUS DR
Mailing Address - Street 2:APT 603
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07302-5546
Mailing Address - Country:US
Mailing Address - Phone:516-476-0404
Mailing Address - Fax:
Practice Address - Street 1:100 CHRISTOPHER COLUMBUS DR
Practice Address - Street 2:APT 603
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07302-5546
Practice Address - Country:US
Practice Address - Phone:516-476-0404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-07
Last Update Date:2011-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist