Fayrouz Pediatric LLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

25MA075893 Issued in NJ

Legal business name

FAYROUZ PEDIATRIC LLC

Practice address

540 Straight Street Second Floor 2E
Paterson, NJ 07503

Phone

(973) 928-3388

Fax

(973) 928-3388

NPI assigned

Sep 25, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Hisham H Gadalla, MDNPI 1689666257

Title

President

Phone

(973) 928-3388

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/ACFEBA

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Hisham H Gadalla, MD

  • Pediatrics Physician
  • Clifton, NJ
  • NPI 1689666257
  Medicare reassignment NPD Authorized official
• Luz Maria Tlatehui Zacatzi, APN

  • Family Nurse Practitioner
  • Clifton, NJ
  • NPI 1619660263
  Medicare reassignment NPD
• Jessica Dominguez, PA-C

  • Physician Assistant
  • Clifton, NJ
  • NPI 1518749092
  NPD (past)
• Shenouda Ibrahim, PA

  • Physician Assistant
  • Clifton, NJ
  • NPI 1588347389
  NPD (past)
• Isra M Qatanani, MD

  • Pediatrics Physician
  • Clifton, NJ
  • NPI 1922758085
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1222300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704758400000",
    "number": "1154571222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "238 OLD WAGON ROAD",
            "city": "FRANKLIN LAKES",
            "state": "NJ",
            "postal_code": "074171626",
            "telephone_number": "973-928-3388",
            "fax_number": "973-928-3388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 STRAIGHT STREET SECOND FLOOR 2E",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "07503",
            "telephone_number": "973-928-3388",
            "fax_number": "973-928-3388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAYROUZ PEDIATRIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-25",
        "last_updated": "2024-01-09",
        "status": "A",
        "authorized_official_last_name": "GADALLA",
        "authorized_official_first_name": "HISHAM",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "973-928-3388",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA075893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mohd Usman Farooqi, DO
• Joseph Newton Farshchian, MD
• Sydney M. Fasulo, MD
• Fateh Pharmacy Inc
• Fateh Pharmacy Inc
• Annette Feanny
• Rebecca Feder-Stamler, D.M.D
• Esther Faye Feinstein
• Mallory Feliciano, DO
• Dalgeling Fermin, NP

• Pediatrics Physician in Paterson, NJ
• Providers in Paterson, NJ by specialty
• Pediatrics Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.