Provider Demographics
NPI:1356798227
Name:HAKIM, FARAH
Entity type:Individual
Prefix:
First Name:FARAH
Middle Name:
Last Name:HAKIM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:EASTERN MEDICAL ASSOCIATES, LLC
Mailing Address - Street 2:SUITE 150-414
Mailing Address - City:WESTBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01581
Mailing Address - Country:US
Mailing Address - Phone:774-535-9641
Mailing Address - Fax:617-716-5572
Practice Address - Street 1:290 TURNPIKE RD
Practice Address - Street 2:STE 150-414
Practice Address - City:WESTBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01581-2843
Practice Address - Country:US
Practice Address - Phone:774-535-9641
Practice Address - Fax:617-716-5572
Is Sole Proprietor?:No
Enumeration Date:2016-05-19
Last Update Date:2016-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPA5654363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant