Individual ProviderMansoor FarookiInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address2094 Merrick Ave, Merrick, NY 11566-3147(516) 600-0676PECOS EnrollmentBased on the most recent information from CMS, provider Mansoor Farooki is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1811922123Provider TypeIndividualFull NameFarooki, MansoorTitleDr.CredentialMDGenderMaleSole ProprietorNoEnumeration Date7/12/2006Last Updated5/8/2024Contact InformationPractice LocationPractice Address2094 Merrick Ave, Merrick, NY 11566-3147Phone(516) 600-0676Fax(718) 708-4282Mailing LocationMailing Address2094 Merrick Ave, Merrick, NY 11566-3147Phone(516) 600-0676Fax(516) 863-2963Provider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense196272New YorkCode207RG0300XDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense196272New YorkProvider IdentifiersIDDescriptionIssuerID02473412DescriptionMedicaidIssuerUnlistedNew York