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General NPI Number Information
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NPI Number | 1245518315
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Entity Type | Organization
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Legal Business Name | EMPIRE AMBULATORY ENDOSCOPY CENTER
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Dates
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Enumeration Date | 07/23/2011
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Last Update Date | 07/23/2011
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Provider Practice Location Address
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Address Line | 5091 AMBOY ROAD
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City | STATEN ISLAND
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State | NY
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Zip | 10312-4722
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Country | US
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Telephone | 718-948-0221
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Fax | 718-948-1787
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Provider Business Mailing Address
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Address Line | 5091 AMBOY ROAD
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City | STATEN ISLAND
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State | NY
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Zip | 10312-4722
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Country | US
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Telephone | 718-948-0221
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Fax | 718-948-1787
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Authorized Official
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Title or Position | OWNER
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Name | DR. SHERIF FARAG
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Credential | MD
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Telephone | 917-751-0416
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0800X
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Taxonomy Name | Endoscopy Clinic/Center
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License Number | 3182
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License Number State | NY
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