Healthcare Provider Details

I. General information

NPI: 1255717708
Provider Name (Legal Business Name): HEATHER FARTHING NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2015
Last Update Date: 05/03/2024
Certification Date: 05/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 NEW SCOTLAND AVE
ALBANY NY
12208-3409
US

IV. Provider business mailing address

75 NEW SCOTLAND AVE
ALBANY NY
12208-3409
US

V. Phone/Fax

Practice location:
  • Phone: 518-549-6634
  • Fax: 518-549-6638
Mailing address:
  • Phone: 518-549-6634
  • Fax: 518-549-6637

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number653219
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number339964
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: