Faryal Azam OD LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

OEG002637 Issued in PA

Legal business name

FARYAL AZAM OD LLC

Practice address

9475 Roosevelt Blvd
Inside Pearle Vision
Philadelphia, PA 19114-2212

Phone

(215) 698-7600

NPI assigned

Jul 12, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Faryal Azam, O.D

Title

Optometrist

Phone

(267) 241-8006

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1373587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1373587200000",
    "number": "1609217140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9475 ROOSEVELT BLVD",
            "address_2": "INSIDE PEARLE VISION",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191142212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9475 ROOSEVELT BLVD",
            "address_2": "INSIDE PEARLE VISION",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191142212",
            "telephone_number": "215-698-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FARYAL AZAM OD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-12",
        "last_updated": "2013-07-12",
        "status": "A",
        "authorized_official_last_name": "AZAM",
        "authorized_official_first_name": "FARYAL",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "267-241-8006",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG002637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anthony Logan Farrow
• Monique R. Farrow, MD
• Yasmeen Faruq
• Donald Gregory Farwell, M.D.
• Michael D Farwell, MD
• Robin Faryna
• Darius Justin Farzad, M.D.
• Charles Fasano, DO
• Megan Fasano
• Oyinlola Oluyinka Fasehun, MD

• Optometrist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Optometrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2013; 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.