Healthcare Provider Details

I. General information

NPI: 1285845941
Provider Name (Legal Business Name): RACHEL FARLEY-LOFTUS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/24/2007
Last Update Date: 03/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1425 POMPTON AVE SUITE 1-1
CEDAR GROVE NJ
07009-1043
US

IV. Provider business mailing address

1425 POMPTON AVE SUITE 1-1
CEDAR GROVE NJ
07009-1043
US

V. Phone/Fax

Practice location:
  • Phone: 973-785-8686
  • Fax: 973-785-8680
Mailing address:
  • Phone: 973-785-8686
  • Fax: 973-785-8680

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number245009
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number25MA09201200
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code207NP0225X
TaxonomyPediatric Dermatology Physician
License Number245009
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: