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General NPI Number Information
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NPI Number | 1356758049
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Entity Type | Organization
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Legal Business Name | JEFFREY FARKAS MD, LLC
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Dates
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Enumeration Date | 07/15/2014
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Last Update Date | 07/15/2014
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Provider Practice Location Address
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Address Line | 150 55TH ST
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City | BROOKLYN
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State | NY
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Zip | 11220-2508
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Country | US
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Telephone | 718-630-6756
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Fax |
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Provider Business Mailing Address
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Address Line | 43 WESTMINSTER AVE
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City | BERGENFIELD
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State | NJ
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Zip | 07621-3913
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Country | US
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Telephone | 201-387-1957
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Fax | 201-387-1036
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | MRS. TAMMIE CHERYL FARKAS
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Credential |
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Telephone | 201-387-1957
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0203X
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Taxonomy Name | Therapeutic Radiology Physician
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License Number | 192230-1
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License Number State | NY
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