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General NPI Number Information
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NPI Number | 1629024757
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Entity Type | Organization
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Legal Business Name | FARES SURGICAL ASSOCIATES, PA
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Dates
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Enumeration Date | 05/26/2006
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 1345 KUSER RD SUITE 1
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City | TRENTON
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State | NJ
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Zip | 08619-3823
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Country | US
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Telephone | 609-585-1400
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Fax | 609-585-2988
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Provider Business Mailing Address
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Address Line | 1345 KUSER RD SUITE 1
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City | TRENTON
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State | NJ
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Zip | 08619-3823
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Country | US
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Telephone | 609-585-1400
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Fax | 609-585-2988
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Authorized Official
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Title or Position | PRESIDENT
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Name | LOUIS G FARES II
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Credential | MD
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Telephone | 609-585-1400
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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 |
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License Number State |
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