=====================================================
General NPI Number Information
=====================================================
NPI Number | 1467610071
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | AYMAN E. FARID, MD LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/30/2008
-----------------------------------------------------
Last Update Date | 06/04/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5091 AMBOY RD
-----------------------------------------------------
City | STATEN ISLAND
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10312-4722
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-984-2100
-----------------------------------------------------
Fax | 718-317-6582
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5091 AMBOY RD
-----------------------------------------------------
City | STATEN ISLAND
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10312-4722
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-984-2100
-----------------------------------------------------
Fax | 718-317-6582
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DOCTOR
-----------------------------------------------------
Name | DR. AYMAN EMIL FARID
-----------------------------------------------------
Credential | M. D
-----------------------------------------------------
Telephone | 718-984-2100
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RC0000X
-----------------------------------------------------
Taxonomy Name | Cardiovascular Disease Physician
-----------------------------------------------------
License Number | 196044
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------