Provider Demographics
NPI:1447315338
Name:BARAKAT, FIRAS LUTFI (MD)
Entity type:Individual
Prefix:DR
First Name:FIRAS
Middle Name:LUTFI
Last Name:BARAKAT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2611 DUNNING DR
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:10598-3800
Mailing Address - Country:US
Mailing Address - Phone:914-245-1527
Mailing Address - Fax:
Practice Address - Street 1:1578 WILLIAMSBRIDGE RD
Practice Address - Street 2:C-LEVEL
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-6265
Practice Address - Country:US
Practice Address - Phone:718-239-2491
Practice Address - Fax:718-239-2494
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY205373-1207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01712349Medicaid
NY777301Medicare ID - Type Unspecified
NY01712349Medicaid