Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 25MA08526900 | NJ |
N | 111NI0900X | Internist | 25MA08526900 | NJ |
N | 207R00000X | Internist | 4301065242 | MI |
N | 111NI0900X | Internist | 4301065242 | MI |
N | 207R00000X | Internist | MD423423 | PA |
N | 111NI0900X | Internist | MD423423 | PA |
Y | 207RG0300X | Geriatric Medicine | 25MA08526900 | NJ |
N | 207RG0300X | Geriatric Medicine | 4301065242 | MI |
N | 207RG0300X | Geriatric Medicine | MD423423 | PA |
N | 207RH0002X | Hospice and Palliative Medicine | 25MA08526900 | NJ |
N | 207RH0002X | Hospice and Palliative Medicine | MD423423 | PA |
NPI | 1396754776 |
---|---|
Provider Name | Dr. Ahmad Farooq |
First Address | Marion, IL 62959-1188 |
Second Address | Pennington, NJ 08534-2520 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2006 |
Last Update Date | 17/05/2021 |