Basic Information
| Provider Information | |||||||||
| NPI: | 1871597575 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ELMI | ||||||||
| FirstName: | FARHAD | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 783311 | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191783311 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4848844500 | ||||||||
| FaxNumber: | 4848840699 | ||||||||
| Practice Location | |||||||||
| Address1: | 2001 FAIRVIEW AVE | ||||||||
| Address2: | |||||||||
| City: | EASTON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 180423915 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6104422082 | ||||||||
| FaxNumber: | 6104382419 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/09/2005 | ||||||||
| LastUpdateDate: | 04/11/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | 25MA07742300 | NJ | N | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | 207UN0901X | MD073352-L | PA | N | Allopathic & Osteopathic Physicians | Nuclear Medicine | Nuclear Cardiology | 207UN0901X | 25MA07742300 | NJ | N | Allopathic & Osteopathic Physicians | Nuclear Medicine | Nuclear Cardiology | 207RC0000X | MD073352-L | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
ID Information
| ID | Type | State | Issuer | Description | 20032365 | 05 | PA | MEDICAID | 1470721 | 01 | PA | KEYSTONE CAPITAL | OTHER | 50020163 | 01 | PA | CAPITAL BLUE CROSS | OTHER | 100823558001 | 05 | PA | MEDICAID | 3298680 | 01 | PA | CIGNA PA | OTHER | 3314373 | 01 | PA | AETNA US HEALTHCARE | OTHER | 1470721 | 01 | PA | HIGHMARK | OTHER | 49581 | 05 | NJ | MEDICAID | P3209785 | 01 | PA | OXFORD | OTHER |