Provider Demographics
NPI:1669486734
Name:FARAH, FUAD S (MD FAAD)
Entity Type:Individual
Prefix:DR
First Name:FUAD
Middle Name:S
Last Name:FARAH
Suffix:
Gender:M
Credentials:MD FAAD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1000 E GENESEE ST
Mailing Address - Street 2:SUITE 601
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13210-1892
Mailing Address - Country:US
Mailing Address - Phone:315-422-8331
Mailing Address - Fax:315-422-3129
Practice Address - Street 1:1000 E GENESEE ST
Practice Address - Street 2:SUITE 601
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-1892
Practice Address - Country:US
Practice Address - Phone:315-422-8331
Practice Address - Fax:315-422-3129
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2012-09-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY132825-3207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1447448758OtherGROUP NPI FOR ORGANIZATIONS
NY1093738965OtherSYRACUSE GROUP NPI