Provider Demographics
NPI:1255492385
Name:TOUFIK FARKOUH MD
Entity Type:Organization
Organization Name:TOUFIK FARKOUH MD
Other - Org Name:TOUFIK FARKOUH MD PLLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:TOUFIK
Authorized Official - Middle Name:P
Authorized Official - Last Name:FARKOUH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:315-624-7500
Mailing Address - Street 1:1656 CHAMPLIN AVE
Mailing Address - Street 2:SUITE 338
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13502-4830
Mailing Address - Country:US
Mailing Address - Phone:315-624-7500
Mailing Address - Fax:315-624-7393
Practice Address - Street 1:1656 CHAMPLIN AVE
Practice Address - Street 2:SUITE 338
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13502-4830
Practice Address - Country:US
Practice Address - Phone:315-624-7500
Practice Address - Fax:315-624-7393
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY196366207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG35237Medicare UPIN
NYDD1363Medicare PIN