1922346832 NPI number — FARIS Z HAKKI, M.D.

Table of content: MATTHEW PRESCOTT THOMPSON LLMSW (NPI 1851023147)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922346832 NPI number — FARIS Z HAKKI, M.D.

Organization/Personal Information

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

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
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:
1922346832
Entity Type Code:
Organization
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:
106 IRVING ST NW
Provider Second Line Business Mailing Address:
POB 408
Provider Business Mailing Address City Name:
WASHINGTON
Provider Business Mailing Address State Name:
DC
Provider Business Mailing Address Postal Code:
20010-2927
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-943-1646
Provider Business Mailing Address Fax Number:
410-721-6363

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:
301-943-1646
Provider Business Practice Location Address Fax Number:
410-721-6363
Provider Enumeration Date:
01/28/2013

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
HAKKI
Authorized Official First Name:
FARIS
Authorized Official Middle Name:
Z
Authorized Official Title or Position:
SOLE OWNER
Authorized Official Telephone Number:
301-943-1646

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: 1437168325 . This is a "INDIVIDUAL NPI" 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".