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General NPI Number Information
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NPI Number | 1134373327
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Entity Type | Organization
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Legal Business Name | FARESICH PARTNER PROCESS, LLC
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Dates
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Enumeration Date | 11/14/2008
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Last Update Date | 04/16/2009
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Provider Practice Location Address
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Address Line | 311 SOUTH LIVINGSTON AVENUE INGLEMOOR REHABILITATION AND CARE CENTER
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City | LIVINGSTON
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State | NJ
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Zip | 07039
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Country | US
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Telephone | 973-994-0221
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Fax |
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Provider Business Mailing Address
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Address Line | 4 MEADOW LARK CT
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City | RANDOLPH
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State | NJ
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Zip | 07869-2128
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Country | US
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Telephone | 973-361-8113
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | MRS. BARBARA K FARESICH
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Credential | APNC
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Telephone | 973-219-7800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 26NN08294900
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License Number State | NJ
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