Provider Demographics
NPI:1700034196
Name:FAROOQ, OSMAN
Entity Type:Individual
Prefix:DR
First Name:OSMAN
Middle Name:
Last Name:FAROOQ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 HODGE AVE
Mailing Address - Street 2:DEPARTMENT OF NEUROLOGY - WCHOB
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14222-2034
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:140 HODGE AVE
Practice Address - Street 2:DEPARTMENT OF NEUROLOGY - WCHOB
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14222-2034
Practice Address - Country:US
Practice Address - Phone:716-878-7840
Practice Address - Fax:716-878-7326
Is Sole Proprietor?:No
Enumeration Date:2008-08-28
Last Update Date:2013-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY0996832084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program