Doctor Name: | DR. GLENN RORY FAUST |
NPI Number: | 1003986456 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 180968 |
Business Practice Address: | 2201 Hempstead Tpke East Meadow, NY - 115541859 |
Business Phone Number: | 5165726705 |
Business Fax Number: | 5165725140 |
Mailing Address: | 2201 Hempstead Tpke, EAST MEADOW |
State: | NY |
Postal Code: | 115541859 |
Phone Number: | 5165726705 |
Fax Number: | 5165725140 |
NPI Enumeration Date: | 11/09/2006 |
NPI Last Update Date: | 04/25/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2086S0129X |
License Number: | 180968 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Surgery |
Taxonomy Specialization: | Vascular Surgery |
Taxonomy Definition: | A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |