Provider Demographics
NPI:1518564244
Name:BUKHARI, FIRDOUS
Entity Type:Individual
Prefix:
First Name:FIRDOUS
Middle Name:
Last Name:BUKHARI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 WESTGATE DR APT 204
Mailing Address - Street 2:
Mailing Address - City:WOBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01801-6425
Mailing Address - Country:US
Mailing Address - Phone:857-544-0290
Mailing Address - Fax:
Practice Address - Street 1:8 WESTGATE DR APT 204
Practice Address - Street 2:
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801-6425
Practice Address - Country:US
Practice Address - Phone:857-544-0290
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-06
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health