Provider Demographics
NPI:1235453416
Name:FARUQUE, ABUL F
Entity Type:Individual
Prefix:DR
First Name:ABUL
Middle Name:F
Last Name:FARUQUE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 N PLANK RD
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-2126
Mailing Address - Country:US
Mailing Address - Phone:845-565-8760
Mailing Address - Fax:845-565-1808
Practice Address - Street 1:59 N PLANK RD
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-2126
Practice Address - Country:US
Practice Address - Phone:845-565-8760
Practice Address - Fax:845-565-1808
Is Sole Proprietor?:No
Enumeration Date:2010-03-17
Last Update Date:2010-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY32467183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist