Provider Demographics
NPI:1912158205
Name:HALANE, FARHAN J
Entity Type:Individual
Prefix:
First Name:FARHAN
Middle Name:J
Last Name:HALANE
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 1:124 PEARL ST STE 402
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197-2663
Mailing Address - Country:US
Mailing Address - Phone:734-484-3500
Mailing Address - Fax:
Practice Address - Street 1:2790 INTERNATIONAL DR
Practice Address - Street 2:#524 A
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-3139
Practice Address - Country:US
Practice Address - Phone:734-834-6061
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-04
Last Update Date:2012-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIE0836C251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health