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General NPI Number Information
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NPI Number | 1548701998
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Entity Type | Individual
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Provider Name | ELLEN MARIE FARR MD
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Gender | Female
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Dates
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Enumeration Date | 03/18/2017
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Last Update Date | 10/01/2024
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Provider Practice Location Address
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Address Line | 601 N 99TH ST
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City | WAUWATOSA
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State | WI
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Zip | 53226-4339
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Country | US
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Telephone | 414-805-3000
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Fax | 414-955-0104
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Provider Business Mailing Address
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Address Line | 601 N 99TH ST
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City | WAUWATOSA
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State | WI
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Zip | 53226-4339
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Country | US
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Telephone | 414-805-3000
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Fax | 414-955-0104
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 35.1458421
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 84417
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License Number State | WI
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