Healthcare Provider Details

I. General information

NPI: 1629774260
Provider Name (Legal Business Name): AOA HEALTHCARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2023
Last Update Date: 02/06/2023
Certification Date: 02/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1041 3RD AVE STE 201
NEW YORK NY
10065-8114
US

IV. Provider business mailing address

1041 3RD AVE STE 201
NEW YORK NY
10065-8114
US

V. Phone/Fax

Practice location:
  • Phone: 212-319-3977
  • Fax: 212-721-0806
Mailing address:
  • Phone: 212-319-3977
  • Fax: 212-721-0806

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: ALI ABOUFARES
Title or Position: CEO
Credential: MD
Phone: 212-319-3977