Provider Demographics
NPI:1023831658
Name:AL-HUSAYNI, FAROOK
Entity type:Individual
Prefix:
First Name:FAROOK
Middle Name:
Last Name:AL-HUSAYNI
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 1:37 HAROLD ST
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:MA
Mailing Address - Zip Code:02067-2545
Mailing Address - Country:US
Mailing Address - Phone:781-363-2848
Mailing Address - Fax:
Practice Address - Street 1:595 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MA
Practice Address - Zip Code:02021-3007
Practice Address - Country:US
Practice Address - Phone:781-828-2375
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-04
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH1000855183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist