Provider Demographics
NPI:1871819086
Name:TAHIR, FARAH (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:MISS
First Name:FARAH
Middle Name:
Last Name:TAHIR
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1245 ELM ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03101-1308
Mailing Address - Country:US
Mailing Address - Phone:603-668-6629
Mailing Address - Fax:
Practice Address - Street 1:1245 ELM ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03101-1308
Practice Address - Country:US
Practice Address - Phone:603-668-6629
Practice Address - Fax:603-622-7680
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-13
Last Update Date:2010-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0767363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant