Individual
DR. FARES DIARBAKERLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
716 BROAD ST, CLIFTON, NJ 07013
(973) 221-3122
(973) 710-0620
Mailing address
716 BROAD ST, CLIFTON, NJ 07013
(862) 571-6939
(973) 710-0620
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
25MA08580900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010048411800
AMERICHOICE MEDICAID HMO
NJ
01
—
01303042
AMERIGROUP MEDICAID HMO
NJ
05
—
0202932
—
NJ
Enumeration date
11/18/2008
Last updated
04/11/2012
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