Healthcare Provider Details

I. General information

NPI: 1518247741
Provider Name (Legal Business Name): DR. DAVID FAOUR
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2011
Last Update Date: 08/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1833 NOSTRAND AVE
BROOKLYN NY
11226-7133
US

IV. Provider business mailing address

2239 CONEY ISLAND AVE
BROOKLYN NY
11223-3337
US

V. Phone/Fax

Practice location:
  • Phone: 917-498-1566
  • Fax:
Mailing address:
  • Phone: 917-498-1566
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number056086
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: