Provider Demographics
NPI:1558380840
Name:FARKOUH, TOUFIK P (MD)
Entity Type:Individual
Prefix:DR
First Name:TOUFIK
Middle Name:P
Last Name:FARKOUH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1656 CHAMPLIN AVENUE
Mailing Address - Street 2:SUITE 338
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13502-4856
Mailing Address - Country:US
Mailing Address - Phone:315-624-7500
Mailing Address - Fax:315-624-7393
Practice Address - Street 1:1656 CHAMPLIN AVENUE
Practice Address - Street 2:SUITE 338
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13502-4856
Practice Address - Country:US
Practice Address - Phone:315-624-7500
Practice Address - Fax:315-624-7393
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2009-12-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY196366207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYDD1363Medicare PIN
NYG35237Medicare UPIN