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General NPI Number Information
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NPI Number | 1982074290
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Entity Type | Organization
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Legal Business Name | FRONTIER MEDICAL CARE
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Dates
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Enumeration Date | 09/29/2015
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Last Update Date | 03/07/2017
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Provider Practice Location Address
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Address Line | 301 TAVISTOCK
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City | CHERRY HILL
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State | NJ
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Zip | 08034-4020
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Country | US
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Telephone | 718-238-2223
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Fax | 718-238-2119
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Provider Business Mailing Address
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Address Line | 421 78TH ST STE C
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City | BROOKLYN
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State | NY
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Zip | 11209-3447
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Country | US
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Telephone | 718-238-2223
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Fax | 718-238-2119
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. FAROUK MARZOUK
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Credential | MD
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Telephone | 718-238-2223
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number |
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License Number State |
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