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General NPI Number Information
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NPI Number | 1477945905
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Entity Type | Organization
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Legal Business Name | ELLENVILLE EMERGENCY MEDICAL ASSOCIATES PLLC
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Dates
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Enumeration Date | 02/20/2015
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Last Update Date | 09/19/2025
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Provider Practice Location Address
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Address Line | 10 HEALTHY WAY
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City | ELLENVILLE
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State | NY
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Zip | 12428-5612
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Country | US
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Telephone | 469-401-2386
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 80250
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City | PHILADELPHIA
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State | PA
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Zip | 19101-1250
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Country | US
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Telephone | 954-939-5000
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Fax | 877-250-6889
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | FAREED NABIEL FAREED
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Credential | MD
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Telephone | 917-854-8007
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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