Provider Demographics
NPI:1871597575
Name:ELMI, FARHAD (MD)
Entity type:Individual
Prefix:
First Name:FARHAD
Middle Name:
Last Name:ELMI
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:PO BOX 783311
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-3311
Mailing Address - Country:US
Mailing Address - Phone:484-884-4500
Mailing Address - Fax:484-884-0699
Practice Address - Street 1:2001 FAIRVIEW AVE
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18042-3915
Practice Address - Country:US
Practice Address - Phone:610-442-2082
Practice Address - Fax:610-438-2419
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2019-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07742300207RC0000X, 207UN0901X
PAMD073352-L207UN0901X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA20032365Medicaid
PA1470721OtherKEYSTONE CAPITAL
PA50020163OtherCAPITAL BLUE CROSS
PA100823558001Medicaid
PA3298680OtherCIGNA PA
PA3314373OtherAETNA US HEALTHCARE
PA1470721OtherHIGHMARK
NJ49581Medicaid
PAP3209785OtherOXFORD
PA071311FM6Medicare PIN
PA3298680OtherCIGNA PA
PAH89029Medicare UPIN