Provider Demographics
NPI:1811087729
Name:FARAH M. ASHRAF, DO, PC
Entity type:Organization
Organization Name:FARAH M. ASHRAF, DO, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FARAH
Authorized Official - Middle Name:M
Authorized Official - Last Name:ASHRAF
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:845-454-9500
Mailing Address - Street 1:74 W CEDAR ST
Mailing Address - Street 2:SUITE 2B
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-1310
Mailing Address - Country:US
Mailing Address - Phone:845-454-9500
Mailing Address - Fax:845-454-2256
Practice Address - Street 1:74 W CEDAR ST
Practice Address - Street 2:SUITE 2B
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-1310
Practice Address - Country:US
Practice Address - Phone:845-454-9500
Practice Address - Fax:845-454-2256
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2008-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY209395207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02188892Medicaid
NYH49672Medicare UPIN
NY02188892Medicaid