MEDICARE: DR. ALI ABOUFARES MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RI0011X	Interventional Cardiology Physician	MD426289	PA
2	207RI0011X	Interventional Cardiology Physician	244925	NY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	CC9269	OTHER	PA	RR MEDICARE GROUP
4	GU039823	OTHER	PA	MEDICARE GROUP
5	P00234348	OTHER	PA	RAILROAD MEDICARE PIN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1508837287
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALI ABOUFARES MD

Provider Business Mailing Address
First Line	:	115 E 57TH ST
Second Line	:	SUITE 1240
City	:	NEW YORK
State	:	NY
Zip	:	10022-2049
Country	:	US
Telephone Number	:	212-319-3977
Fax Number	:	212-319-4263

Provider Business Practice Location Address
First Line	:	115 E 57TH ST
Second Line	:	SUITE 1240
City	:	NEW YORK
State	:	NY
Zip	:	10022-2049
Country	:	US
Telephone Number	:	212-319-3977
Fax Number	:	212-319-4263

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/30/2006
Last Update Date	:	05/02/2016

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Directions to “ DR. ALI ABOUFARES MD” Practice Location

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