Faruk Moinuddin Koreishi, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

119187 Issued in NY

Practice address

6637 Main St
Williamsville, NY 14221-5974

Phone

(716) 632-1595

Fax

(716) 204-4895

NPI assigned

Nov 13, 2006

Last updated

May 10, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462838400000",
    "number": "1689745465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1176 MAIN ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142092102",
            "telephone_number": "716-881-7978",
            "fax_number": "716-887-2991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6637 MAIN ST",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142215974",
            "telephone_number": "716-632-1595",
            "fax_number": "716-204-4895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOREISHI",
        "first_name": "FARUK",
        "middle_name": "MOINUDDIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-13",
        "last_updated": "2016-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "119187",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00615898",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Ophthalmology Physician in Williamsville, NY
• Providers in Williamsville, NY by specialty
• Ophthalmology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2016; 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.