Provider Demographics
NPI:1194743989
Name:FARANO, PETER J (MD)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:J
Last Name:FARANO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 8500-6335
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-0001
Mailing Address - Country:US
Mailing Address - Phone:215-807-8000
Mailing Address - Fax:215-807-8235
Practice Address - Street 1:3998 RED LION RD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19114-1436
Practice Address - Country:US
Practice Address - Phone:215-612-4000
Practice Address - Fax:215-807-8235
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD032702E207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0011723870007Medicaid
PA28898OtherHEALTH PARTNERS
PA850205OtherAETNA CONTRACT
PAPA0017269OtherTRICARE
PA0011723870001Medicaid
PA0011723870002Medicaid
PA001824OtherPERSONAL CHOICE
PA0217173000OtherKEYSTONE IBC
PA001824OtherHIGHMARK BLUE SHIELD
PA1031970OtherKEYSTONE MERCY
PA7390789OtherCIGNA
PA01172387-02OtherAMERICHOICE
PA001824OtherPERSONAL CHOICE
PA001824JL1Medicare PIN