Provider Demographics
NPI:1598778896
Name:SHAFIK, FARID FOUAD (MD, FACS)
Entity Type:Individual
Prefix:DR
First Name:FARID
Middle Name:FOUAD
Last Name:SHAFIK
Suffix:
Gender:M
Credentials:MD, FACS
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:55 MERIDEN AVENUE
Mailing Address - Street 2:SUITE 2D
Mailing Address - City:SOUTHINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06489-3235
Mailing Address - Country:US
Mailing Address - Phone:860-621-4412
Mailing Address - Fax:860-276-5262
Practice Address - Street 1:318 NORTH MAIN STREET
Practice Address - Street 2:UNIT 2
Practice Address - City:SOUTHINGTON
Practice Address - State:CT
Practice Address - Zip Code:06489
Practice Address - Country:US
Practice Address - Phone:860-621-4412
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT036594207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
180000833Medicare ID - Type Unspecified
G12248Medicare UPIN