Provider Demographics
NPI:1265860217
Name:FAISAL RAFIQ MD. PC
Entity Type:Organization
Organization Name:FAISAL RAFIQ MD. PC
Other - Org Name:EVOLVE PSYCHIATRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PSYCHIATRIST/ OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FAISAL
Authorized Official - Middle Name:MUHAMMAD
Authorized Official - Last Name:RAFIQ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:518-605-7505
Mailing Address - Street 1:1873 WESTERN AVE
Mailing Address - Street 2:2ND FLOOR SUITE 202
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12203-5028
Mailing Address - Country:US
Mailing Address - Phone:518-605-7505
Mailing Address - Fax:855-244-5206
Practice Address - Street 1:1873 WESTERN AVE
Practice Address - Street 2:2ND FLOOR SUITE 202
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12203-5028
Practice Address - Country:US
Practice Address - Phone:518-605-7505
Practice Address - Fax:855-244-5206
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-29
Last Update Date:2013-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2714012084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty