Individual
FAZAL G FAROQUI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
450 WAVERLY AVE STE 1, PATCHOGUE, NY 11772-1555
(516) 769-6409
(631) 223-1900
Mailing address
1 E ROE BLVD, PATCHOGUE, NY 11772-2631
(631) 475-3900
(631) 475-5606
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
239825
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02772190
—
NY
01
—
245B1
BCBS
NY
Enumeration date
07/05/2006
Last updated
04/08/2026
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