Provider Demographics
NPI:1255951745
Name:KAMAL, FARIS MOH'D MAHDI ALHAJ SA (MD)
Entity type:Individual
Prefix:
First Name:FARIS
Middle Name:MOH'D MAHDI ALHAJ SA
Last Name:KAMAL
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 1:101 DATES DRIVE
Mailing Address - Street 2:INTERNAL MEDICINE RESIDENCY CAYUGA MEDICAL CENTER
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850
Mailing Address - Country:US
Mailing Address - Phone:607-274-4011
Mailing Address - Fax:
Practice Address - Street 1:101 DATES DRIVE
Practice Address - Street 2:INTERNAL MEDICINE RESIDENCY CAYUGA MEDICAL CENTER
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850
Practice Address - Country:US
Practice Address - Phone:607-339-0630
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-24
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program