Ehsan Farag, AGNP-C

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

26NJ15466200 Issued in NJ

Practice address

785 W Sherman Ave
Vineland, NJ 08360-6913

Phone

(856) 451-4700

NPI assigned

Sep 10, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1757462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763337600000",
    "number": "1306727946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "785 W SHERMAN AVE",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083606913",
            "telephone_number": "908-848-3860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "785 W SHERMAN AVE",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083606913",
            "telephone_number": "856-451-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARAG",
        "first_name": "EHSAN",
        "name_prefix": "Mrs.",
        "credential": "AGNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-10",
        "last_updated": "2025-11-17",
        "certification_date": "2025-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NJ",
            "license": "26NJ15466200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susana Fajardo
• Robert Paul Falconiero, D.O.
• Famcare, Inc
• Jacqualyn S Fanelle, CRNA
• Joseph William Fanelle, MD
• Bianca Farmer
• Tyrice Nichele Farrington
• Peter James Federici, MD
• Rami Fedil, MD
• Coulston Feldman

• Gerontology Nurse Practitioner in Vineland, NJ
• Providers in Vineland, NJ by specialty
• Gerontology Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.