Provider Demographics
NPI:1275872566
Name:ABDULLAH, FARUQ (RPH)
Entity Type:Individual
Prefix:
First Name:FARUQ
Middle Name:
Last Name:ABDULLAH
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8747 139TH ST
Mailing Address - Street 2:
Mailing Address - City:BRIARWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11435-3024
Mailing Address - Country:US
Mailing Address - Phone:718-971-0502
Mailing Address - Fax:
Practice Address - Street 1:501 W 113TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-8073
Practice Address - Country:US
Practice Address - Phone:866-948-9926
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-06
Last Update Date:2013-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY057336183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist