Provider Demographics
NPI:1740801489
Name:FAROOQ, WASEEM (MD)
Entity Type:Individual
Prefix:DR
First Name:WASEEM
Middle Name:
Last Name:FAROOQ
Suffix:
Gender:M
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:UNIVERSITY OF CONNECTICUT SCHOOL OF MEDICINE
Mailing Address - Street 2:263 FARMINGTON AVENUE FARMINGTON
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06030-1921
Mailing Address - Country:US
Mailing Address - Phone:860-679-4272
Mailing Address - Fax:860-679-4624
Practice Address - Street 1:114 WOODLAND ST
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06105-1208
Practice Address - Country:US
Practice Address - Phone:860-679-2147
Practice Address - Fax:860-679-4624
Is Sole Proprietor?:No
Enumeration Date:2020-05-05
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program