Individual
BASHAR FAHOUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
506 6TH ST, DEPT OF SURGERY, BROOKLYN, NY 11215-3609
(718) 780-3288
(718) 780-3154
Mailing address
270 FLAGG PL, STATEN ISLAND, NY 10304-1134
(718) 780-3290
(718) 780-3154
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
192383
NY
2086S0102X
Surgical Critical Care Physician
Primary
192383
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01484844
—
NY
Enumeration date
11/24/2006
Last updated
09/20/2024
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