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General NPI Number Information
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NPI Number | 1548434665
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Entity Type | Individual
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Provider Name | JORDAN PHILLIP FARKAS MD
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Gender | Male
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Dates
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Enumeration Date | 04/18/2008
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Last Update Date | 09/14/2018
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Provider Practice Location Address
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Address Line | 570 SYLVAN AVE STE 202
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City | ENGLEWOOD CLIFFS
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State | NJ
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Zip | 07632-3132
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Country | US
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Telephone | 201-587-4961
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Fax |
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Provider Business Mailing Address
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Address Line | 191 DEVON RD
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City | TENAFLY
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State | NJ
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Zip | 07670-3125
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Country | US
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Telephone | 201-587-4961
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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 | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | P6614
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License Number State | TX
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