Provider Demographics
NPI:1982074290
Name:FRONTIER MEDICAL CARE
Entity Type:Organization
Organization Name:FRONTIER MEDICAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FAROUK
Authorized Official - Middle Name:
Authorized Official - Last Name:MARZOUK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-238-2223
Mailing Address - Street 1:421 78TH ST
Mailing Address - Street 2:STE C
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-3447
Mailing Address - Country:US
Mailing Address - Phone:718-238-2223
Mailing Address - Fax:718-238-2119
Practice Address - Street 1:301 TAVISTOCK
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-4020
Practice Address - Country:US
Practice Address - Phone:718-238-2223
Practice Address - Fax:718-238-2119
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-29
Last Update Date:2017-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty