Provider Demographics
NPI:1801115381
Name:ARYAFAR, FARIBORZ (BS)
Entity type:Individual
Prefix:
First Name:FARIBORZ
Middle Name:
Last Name:ARYAFAR
Suffix:
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:432 8TH ST
Mailing Address - Street 2:
Mailing Address - City:PALISADES PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07650-2308
Mailing Address - Country:US
Mailing Address - Phone:201-242-0222
Mailing Address - Fax:973-759-2027
Practice Address - Street 1:543 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:EAST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07018-1922
Practice Address - Country:US
Practice Address - Phone:973-677-7880
Practice Address - Fax:973-677-5672
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-24
Last Update Date:2010-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02513600183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist