Provider Demographics
NPI:1760630404
Name:FALTAS, BISHOY SOBHY MORRIS (MD)
Entity Type:Individual
Prefix:DR
First Name:BISHOY
Middle Name:SOBHY MORRIS
Last Name:FALTAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:575 LEXINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-6102
Mailing Address - Country:US
Mailing Address - Phone:646-962-2072
Mailing Address - Fax:646-962-1603
Practice Address - Street 1:520 E 70TH ST
Practice Address - Street 2:STARR 341
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-9800
Practice Address - Country:US
Practice Address - Phone:646-962-2072
Practice Address - Fax:646-962-1603
Is Sole Proprietor?:No
Enumeration Date:2008-09-07
Last Update Date:2016-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY259380208M00000X, 390200000X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY256245OtherMVP/PC ROCHESTER AREA LEGACY NUMBER
NY03121042Medicaid
NY10712AMedicare PIN
NY03121042Medicaid
NYJ400056974Medicare PIN
NYJ400056990Medicare PIN
NY256245OtherMVP/PC ROCHESTER AREA LEGACY NUMBER