Healthcare Provider Details

I. General information

NPI: 1205924248
Provider Name (Legal Business Name): JOHN J FARKAS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 12/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

842 CLIFTON AVE STE 6
CLIFTON NJ
07013-1800
US

IV. Provider business mailing address

1130 MCBRIDE AVE FL 3
WOODLAND PARK NJ
07424-3806
US

V. Phone/Fax

Practice location:
  • Phone: 973-777-5717
  • Fax: 201-632-4815
Mailing address:
  • Phone: 973-785-2277
  • Fax: 973-785-2355

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberMA48276
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: