Individual
DR. FARRUKH MANSOOR KORAISHY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD, PHD
Contact information
Practice address
101 NICOLLS RD, STONY BROOK, NY 11794-0001
(631) 444-1617
Mailing address
101 NICOLLS RD, STONY BROOK, NY 11794-0001
(313) 522-9036
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301079643
MI
207RN0300X
Nephrology Physician
Primary
300229
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110F376980
BCBSM
MI
Enumeration date
03/23/2006
Last updated
06/22/2022
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