Provider Demographics
NPI:1295226322
Name:FAROOQI, FARKHANDA IZHAR (DNP AGPCNP- BC PMHNP)
Entity Type:Individual
Prefix:DR
First Name:FARKHANDA
Middle Name:IZHAR
Last Name:FAROOQI
Suffix:
Gender:F
Credentials:DNP AGPCNP- BC PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:477 MINE BROOK RD
Mailing Address - Street 2:
Mailing Address - City:BERNARDSVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07924-2007
Mailing Address - Country:US
Mailing Address - Phone:201-744-3191
Mailing Address - Fax:
Practice Address - Street 1:477 MINE BROOK RD
Practice Address - Street 2:
Practice Address - City:BERNARDSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07924-2007
Practice Address - Country:US
Practice Address - Phone:201-744-3191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-24
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY308691363LP2300X
NJ26NJ008412002084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care