Provider Demographics
NPI:1609601103
Name:ADEN, FARAHAN IBRAHIM
Entity type:Individual
Prefix:
First Name:FARAHAN
Middle Name:IBRAHIM
Last Name:ADEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:904 THOMAS AVE
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:ND
Mailing Address - Zip Code:58401-6553
Mailing Address - Country:US
Mailing Address - Phone:860-834-5354
Mailing Address - Fax:
Practice Address - Street 1:805 2ND AVE SW
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:ND
Practice Address - Zip Code:58401-4605
Practice Address - Country:US
Practice Address - Phone:860-849-6880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-04
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide