Provider Demographics
NPI:1679718951
Name:FAROOQI, RIAZ H (BS PHARMACY)
Entity Type:Individual
Prefix:MR
First Name:RIAZ
Middle Name:H
Last Name:FAROOQI
Suffix:
Gender:M
Credentials:BS PHARMACY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:640 WESTBROOK RD
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07450-2129
Mailing Address - Country:US
Mailing Address - Phone:201-447-5595
Mailing Address - Fax:201-447-0854
Practice Address - Street 1:212 PALISADE AVE
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-1116
Practice Address - Country:US
Practice Address - Phone:201-447-5595
Practice Address - Fax:201-447-0854
Is Sole Proprietor?:No
Enumeration Date:2008-12-15
Last Update Date:2008-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28R102181800183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist