1649250366 NPI number — ABDUL MEGUID ELFAR

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649250366 NPI number — ABDUL MEGUID ELFAR

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

ELFAR

Provider First Name:

ABDUL

Provider Middle Name:

MEGUID

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

Provider Gender Code:

M

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1649250366

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

07/31/2014

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

203 ROOSEVELT DRIVE

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

FISHKILL

Provider Business Mailing Address State Name:

NY

Provider Business Mailing Address Postal Code:

12524

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

203-434-3312

Provider Business Mailing Address Fax Number:

Provider First Line Business Practice Location Address:

203 ROOSEVELT DRIVE

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

FISHKILL

Provider Business Practice Location Address State Name:

NY

Provider Business Practice Location Address Postal Code:

12524

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

203-434-3312

Provider Business Practice Location Address Fax Number:

Provider Enumeration Date:

01/19/2006

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 207P00000X , with the licence number:  203916 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 1004537D815 . This is a "CDPHP PIN" identifier . This identifiers is of the category "OTHER".
• Identifier: 1241875 . This is a "AETNA HMO PIN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
• Identifier: 0143276 . This is a "GHI PPO PIN" identifier . This identifiers is of the category "OTHER".
• Identifier: 131740118 . This is a "GALAXY HEALTH PIN" identifier . This identifiers is of the category "OTHER".
• Identifier: 2402Q1 . This is a "BLUE CROSS PIN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
• Identifier: P3664800 . This is a "OXFORD PIN" identifier . This identifiers is of the category "OTHER".
• Identifier: 060412000012 . This is a "FIDELIS PIN" identifier . This identifiers is of the category "OTHER".
• Identifier: 02049076 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
• Identifier: 5C4628 . This is a "HEALTHNET PIN" identifier . This identifiers is of the category "OTHER".
• Identifier: 7670434 . This is a "AETNA PPO PIN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
• Identifier: 796337 . This is a "MVP PIN" identifier . This identifiers is of the category "OTHER".
• Identifier: 0000000116338 . This is a "GHI HMO PIN" identifier . This identifiers is of the category "OTHER".