1568519585 NPI number — DR. FAIZEH ABDELKAREEM FAOURI PSYCHOLOGIST LLP

Table of content: DR. FAIZEH ABDELKAREEM FAOURI PSYCHOLOGIST LLP (NPI 1568519585)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568519585 NPI number — DR. FAIZEH ABDELKAREEM FAOURI PSYCHOLOGIST LLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FAOURI
Provider First Name:
FAIZEH
Provider Middle Name:
ABDELKAREEM
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PSYCHOLOGIST LLP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ALFAOURI
Provider Other First Name:
FAIZEH
Provider Other Middle Name:
ABDEL-KAREEM
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1568519585
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/09/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
13229 E 12 MILE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WARREN
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48088-3647
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8740 JOSEPH CAMPAU ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HAMTRAMCK
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48212-3721
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
313-875-4685
Provider Business Practice Location Address Fax Number:
313-875-4701
Provider Enumeration Date:
01/04/2007

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: 103T00000X , with the licence number:  6301013425 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 3434247 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".




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