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General NPI Number Information
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NPI Number | 1396418331
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Entity Type | Individual
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Provider Name | FARIS NAWFAL OMAR ALBAKOAA MD
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Gender | Male
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Dates
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Enumeration Date | 07/27/2021
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Last Update Date | 09/15/2025
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Provider Practice Location Address
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Address Line | 6900 HAMILTON BLVD
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City | TREXLERTOWN
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State | PA
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Zip | 18087-9101
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Country | US
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Telephone | 610-402-0101
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Fax |
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Provider Business Mailing Address
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Address Line | 2100 MACK BLVD FL 4
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City | ALLENTOWN
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State | PA
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Zip | 18103-5622
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD485553
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | MT222254
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License Number State | PA
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