Provider Demographics
NPI:1033249750
Name:SHROFF, FAROOK K (MD, FACC)
Entity type:Individual
Prefix:DR
First Name:FAROOK
Middle Name:K
Last Name:SHROFF
Suffix:
Gender:M
Credentials:MD, FACC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 OLD MILL RD
Mailing Address - Street 2:
Mailing Address - City:WILKES BARRE
Mailing Address - State:PA
Mailing Address - Zip Code:18702-7318
Mailing Address - Country:US
Mailing Address - Phone:570-881-9639
Mailing Address - Fax:570-655-4103
Practice Address - Street 1:575 N RIVER ST
Practice Address - Street 2:
Practice Address - City:WILKES BARRE
Practice Address - State:PA
Practice Address - Zip Code:18702-2634
Practice Address - Country:US
Practice Address - Phone:570-829-8111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD035572L207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA19320OtherGEISINGER HEALTH PLAN
PA440480OtherFIRST PRIORITY HEALTH
PA2Y7701OtherHEALTH NET
PA025159OtherHIGHMARK BLUE SHIELD
PA000649873Medicaid
PA2Y7701OtherHEALTH NET
PA19320OtherGEISINGER HEALTH PLAN
PA2Y7701OtherHEALTH NET