Provider Demographics
NPI:1437563202
Name:FAROOQ ABDULLA MD
Entity Type:Organization
Organization Name:FAROOQ ABDULLA MD
Other - Org Name:NEOPEDIATRICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER & PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:FAROOQ
Authorized Official - Middle Name:
Authorized Official - Last Name:ABDULLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD, FAAP, IBCLC, M
Authorized Official - Phone:702-301-0565
Mailing Address - Street 1:PO BOX 95306
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89193-5306
Mailing Address - Country:US
Mailing Address - Phone:702-948-8897
Mailing Address - Fax:702-549-3178
Practice Address - Street 1:2501 W CHARLESTON BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-2127
Practice Address - Country:US
Practice Address - Phone:702-948-8897
Practice Address - Fax:702-549-3178
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-19
Last Update Date:2014-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV64132080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal MedicineGroup - Single Specialty