Individual
FARAH MOUSTAFA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
593 EDDY ST, PROVIDENCE, RI 02903-4923
(401) 444-7139
Mailing address
593 EDDY ST, PROVIDENCE, RI 02903-4923
(401) 444-7139
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
LP03690
RI
207R00000X
Internal Medicine Physician
264225
MA
Other
Enumeration date
06/14/2015
Last updated
07/28/2016
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