Provider Demographics
NPI:1649250366
Name:ELFAR, ABDUL MEGUID
Entity type:Individual
Prefix:
First Name:ABDUL
Middle Name:MEGUID
Last Name:ELFAR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 ROOSEVELT DRIVE
Mailing Address - Street 2:
Mailing Address - City:FISHKILL
Mailing Address - State:NY
Mailing Address - Zip Code:12524
Mailing Address - Country:US
Mailing Address - Phone:203-434-3312
Mailing Address - Fax:
Practice Address - Street 1:203 ROOSEVELT DRIVE
Practice Address - Street 2:
Practice Address - City:FISHKILL
Practice Address - State:NY
Practice Address - Zip Code:12524
Practice Address - Country:US
Practice Address - Phone:203-434-3312
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2014-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY203916207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
1004537D815OtherCDPHP PIN
NY1241875OtherAETNA HMO PIN
0143276OtherGHI PPO PIN
131740118OtherGALAXY HEALTH PIN
NY2402Q1OtherBLUE CROSS PIN
P3664800OtherOXFORD PIN
060412000012OtherFIDELIS PIN
NY02049076Medicaid
5C4628OtherHEALTHNET PIN
NY7670434OtherAETNA PPO PIN
796337OtherMVP PIN
0000000116338OtherGHI HMO PIN
796337OtherMVP PIN
NY7670434OtherAETNA PPO PIN
33025FMedicare ID - Type Unspecified
NYRA4049Medicare PIN
G32138Medicare UPIN