Provider Demographics
NPI:1023761145
Name:HUSAIN, FARWA (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:FARWA
Middle Name:
Last Name:HUSAIN
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 DAHLIA CT
Mailing Address - Street 2:
Mailing Address - City:PISCATAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08854-6673
Mailing Address - Country:US
Mailing Address - Phone:469-371-0532
Mailing Address - Fax:
Practice Address - Street 1:575 ROUTE 28 BLDG 1
Practice Address - Street 2:
Practice Address - City:RARITAN
Practice Address - State:NJ
Practice Address - Zip Code:08869-1354
Practice Address - Country:US
Practice Address - Phone:732-301-4909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-28
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00694800235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ568946544OtherBCBS
NJ5874OtherHEALTH PARTNERS
NJ236Medicaid