Provider Demographics
NPI:1417643198
Name:FAROOQ, ZENAB (MD)
Entity Type:Individual
Prefix:
First Name:ZENAB
Middle Name:
Last Name:FAROOQ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 E MOUNTAIN BLVD
Mailing Address - Street 2:
Mailing Address - City:WILKES BARRE
Mailing Address - State:PA
Mailing Address - Zip Code:18711
Mailing Address - Country:US
Mailing Address - Phone:570-808-3746
Mailing Address - Fax:570-808-5967
Practice Address - Street 1:1000 E MOUNTAIN BLVD
Practice Address - Street 2:
Practice Address - City:WILKES BARRE
Practice Address - State:PA
Practice Address - Zip Code:18711
Practice Address - Country:US
Practice Address - Phone:570-808-3746
Practice Address - Fax:570-808-5967
Is Sole Proprietor?:No
Enumeration Date:2023-04-14
Last Update Date:2024-01-23
Deactivation Date:2023-11-17
Deactivation Code:
Reactivation Date:2024-01-23
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program