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General NPI Number Information
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NPI Number | 1245288273
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Entity Type | Individual
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Provider Name | ROBERT FARRAR M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/04/2006
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Last Update Date | 09/10/2013
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Provider Practice Location Address
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Address Line | 61 S FULLERTON AVE
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City | MONTCLAIR
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State | NJ
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Zip | 07042-2634
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Country | US
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Telephone | 248-505-0055
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Fax |
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Provider Business Mailing Address
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Address Line | 61 S FULLERTON AVE
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City | MONTCLAIR
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State | NJ
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Zip | 07042-2634
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Country | US
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Telephone | 248-505-0055
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 4301049866
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | D03604000
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License Number State | NJ
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