Provider Demographics
NPI:1699861567
Name:FARAG, AYMAN ROUSHDY (MD)
Entity type:Individual
Prefix:DR
First Name:AYMAN
Middle Name:ROUSHDY
Last Name:FARAG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:80 MARCUS DRIVE
Mailing Address - Street 2:
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747
Mailing Address - Country:US
Mailing Address - Phone:631-391-8366
Mailing Address - Fax:631-454-4161
Practice Address - Street 1:327 BEACH 19TH ST
Practice Address - Street 2:DEPT OF ANESTHESIOLOGY
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11691-4423
Practice Address - Country:US
Practice Address - Phone:718-869-7000
Practice Address - Fax:718-869-7000
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2015-02-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY235487207L00000X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine