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General NPI Number Information
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NPI Number | 1225323728
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Entity Type | Organization
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Legal Business Name | LOUIS G. FARES II, MD, FACS, LLC
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Dates
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Enumeration Date | 06/13/2011
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Last Update Date | 06/20/2016
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Provider Practice Location Address
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Address Line | 116 WASHINGTON CROSSING RD SUITE 1
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City | PENNINGTON
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State | NJ
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Zip | 08534-2514
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Country | US
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Telephone | 609-737-2223
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Fax | 609-737-2350
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Provider Business Mailing Address
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Address Line | 116 WASHINGTON CROSSING RD SUITE 1
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City | PENNINGTON
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State | NJ
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Zip | 08534-2514
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Country | US
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Telephone | 609-737-2223
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Fax | 609-737-2350
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | LOUIS G FARES II
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Credential | MD
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Telephone | 609-737-2223
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 25MA03951500
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License Number State | NJ
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