Healthcare Provider Details

I. General information

NPI: 1962467308
Provider Name (Legal Business Name): FARAH WADIA BRINK MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2006
Last Update Date: 06/09/2025
Certification Date: 06/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

655 E LIVINGSTON AVE
COLUMBUS OH
43205-2618
US

IV. Provider business mailing address

700 CHILDRENS DR
COLUMBUS OH
43205-2664
US

V. Phone/Fax

Practice location:
  • Phone: 614-722-6200
  • Fax: 614-722-3196
Mailing address:
  • Phone: 614-722-3283
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35084343
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code2080C0008X
TaxonomyChild Abuse Pediatrics Physician
License Number35084343
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: