Maryam Farag
Dentist, Oral and Maxillofacial Surgery in Rutherford, NJ. Individual provider (NPI-1).
NPI number1295076255
StatusActive
Last updated in NPPESDec 2, 2020
Details
- NPI
- 1295076255
- Entity type
- Individual (NPI-1)
- Name
- Maryam Farag
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Mar 14, 2013
- Certification date
- Dec 2, 2020
- Last updated
- Dec 2, 2020
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - ORAL SURGERY
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility No · Hospice Yes
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223S0112X | Dentist, Oral and Maxillofacial Surgery | 0238832 | NY | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – |
Practice location
41 Preble PlRutherford, NJ 07070-2610
Phone 201-316-5423
Mailing address
41 Preble PlRutherford, NJ 07070-2610
Phone 201-316-5423
Is something wrong?
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