Provider Demographics
NPI:1245200070
Name:FAROOQUI, MASIH U (MD)
Entity Type:Individual
Prefix:DR
First Name:MASIH
Middle Name:U
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 1:271 CAREW STREET
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01104
Mailing Address - Country:US
Mailing Address - Phone:413-748-7370
Mailing Address - Fax:413-748-7376
Practice Address - Street 1:271 CAREW STREET
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01104
Practice Address - Country:US
Practice Address - Phone:413-734-8254
Practice Address - Fax:413-747-8545
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2014-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA76365207R00000X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA11043610Medicaid
CT003116359Medicaid
CT003116359Medicaid
110183528Medicare PIN
G44019Medicare UPIN