Provider Demographics
NPI:1205804127
Name:FAROOQUI, SHAHID WASEEM (MD)
Entity type:Individual
Prefix:DR
First Name:SHAHID
Middle Name:WASEEM
Last Name:FAROOQUI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:20 WHITE RD
Mailing Address - Street 2:SUITE B.
Mailing Address - City:SHREWSBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:07702-4039
Mailing Address - Country:US
Mailing Address - Phone:732-747-4723
Mailing Address - Fax:732-747-5998
Practice Address - Street 1:20 WHITE RD
Practice Address - Street 2:STE.B
Practice Address - City:SHREWSBURY
Practice Address - State:NJ
Practice Address - Zip Code:07702-4039
Practice Address - Country:US
Practice Address - Phone:732-747-4723
Practice Address - Fax:732-747-5998
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMA50568207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJE59912Medicare UPIN