MEDICARE: DEBORAH LYNN FAROLINO MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RH0003X	Hematology & Oncology Physician	146925	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1659377968
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBORAH LYNN FAROLINO MD

Provider Business Mailing Address
First Line	:	275 ZIMMERMAN BLVD
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14223-1021
Country	:	US
Telephone Number	:	716-873-0164
Fax Number	:

Provider Business Practice Location Address
First Line	:	3495 BAILEY AVE
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14215-1129
Country	:	US
Telephone Number	:	716-834-9200
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2005
Last Update Date	:	07/08/2007

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