Provider Demographics
NPI:1194785584
Name:FARID, ASIM (MD)
Entity type:Individual
Prefix:
First Name:ASIM
Middle Name:
Last Name:FARID
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 LATTIMORE RD
Mailing Address - Street 2:SUITE 270
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14620-4159
Mailing Address - Country:US
Mailing Address - Phone:585-244-5670
Mailing Address - Fax:585-244-4298
Practice Address - Street 1:125 LATTIMORE RD
Practice Address - Street 2:SUITE 270
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620-4159
Practice Address - Country:US
Practice Address - Phone:585-244-5670
Practice Address - Fax:585-244-4298
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-28
Last Update Date:2015-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY222664208600000X, 208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY5150484OtherAETNA
NYMDG257OtherPREFERRED CARE
NYP010222664OtherBLUES
NY1194785584OtherNPI NUMBER
NY02208799Medicaid
NYMDG257OtherPREFERRED CARE