Provider Demographics
NPI:1639121148
Name:FARAG, AMAL F (MD)
Entity Type:Individual
Prefix:DR
First Name:AMAL
Middle Name:F
Last Name:FARAG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 DOWNING ST
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-2220
Mailing Address - Country:US
Mailing Address - Phone:718-630-2808
Mailing Address - Fax:718-630-3761
Practice Address - Street 1:800 POLY PL
Practice Address - Street 2:MEDICAL SERVICE(111)
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-7104
Practice Address - Country:US
Practice Address - Phone:718-630-2808
Practice Address - Fax:718-630-3761
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY129138207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine