Provider Demographics
NPI:1598964090
Name:FAROOQ, SADAF BASHIR (MD)
Entity Type:Individual
Prefix:DR
First Name:SADAF
Middle Name:BASHIR
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 1:93 FOUNTAYNE LN
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648-2679
Mailing Address - Country:US
Mailing Address - Phone:609-570-0332
Mailing Address - Fax:
Practice Address - Street 1:231 CROSSWICKS RD
Practice Address - Street 2:SUITE.2
Practice Address - City:BORDENTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08505-2602
Practice Address - Country:US
Practice Address - Phone:609-298-7204
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-13
Last Update Date:2008-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08388900208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics