Farooq Dada LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

License

040063 Issued in CT

Legal business name

FAROOQ DADA LLC

Practice address

2275 Silas Deane Hwy
Rocky Hill, CT 06067-2329

Phone

(860) 523-9426

NPI assigned

Jan 23, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Mohammad Farooq Dada, M.D.

Title

Physician

Phone

(860) 523-9426

Specialties & licenses 3

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1358899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439337600000",
    "number": "1740528967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 TRUMBULL LN",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061172756",
            "telephone_number": "860-523-9426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2275 SILAS DEANE HWY",
            "city": "ROCKY HILL",
            "state": "CT",
            "postal_code": "060672329",
            "telephone_number": "860-523-9426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAROOQ DADA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-23",
        "last_updated": "2015-08-12",
        "status": "A",
        "authorized_official_last_name": "DADA",
        "authorized_official_first_name": "MOHAMMAD",
        "authorized_official_middle_name": "FAROOQ",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "860-523-9426",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "CT",
            "license": "040063",
            "primary": true
        },
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "CT",
            "license": "040063",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CT",
            "license": "040063",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001400639",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Vincent Joseph Fazzino, DMD
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• Mental Health Clinic/Center (Including Community Mental Health Center) in Rocky Hill, CT
• Providers in Rocky Hill, CT by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.