1437168325 NPI number — FARIS HAKKI M.D.

Table of content: FARIS HAKKI M.D. (NPI 1437168325)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437168325 NPI number — FARIS HAKKI M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HAKKI
Provider First Name:
FARIS
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1437168325
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/28/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4618 FOXHALL CRES NW
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WASHINGTON
Provider Business Mailing Address State Name:
DC
Provider Business Mailing Address Postal Code:
20007-1061
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
202-744-6314
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
106 IRVING ST NW
Provider Second Line Business Practice Location Address:
POB 408
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20010-2927
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
202-877-5007
Provider Business Practice Location Address Fax Number:
202-877-0090
Provider Enumeration Date:
08/07/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2086S0129X , with the licence number:  MD21291 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 521958465 . This is a "TAX ID FOR HAKKI MEDICAL ASSOCIATION" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 026637100 , issued by the state of ( DC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 796207 . This is a "SOLO PRACTICE PTAN 792607" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".




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