Individual
DR. FARRAH J MATEEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
55 FRUIT ST, AC720, DEPARTMENT OF NEUROLOGY, BOSTON, MA 02114-2621
(617) 726-2383
Mailing address
55 FRUIT ST, AC-720, DEPARTMENT OF NEUROLOGY, BOSTON, MA 02114-2621
(410) 935-5181
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
48967
MN
2084N0400X
Neurology Physician
036174248
IL
2084N0400X
Neurology Physician
Primary
D69799
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036671400
—
MD
05
—
507948000
—
MN
Enumeration date
10/12/2006
Last updated
08/14/2025
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