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General NPI Number Information
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NPI Number | 1932667359
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Entity Type | Individual
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Provider Name | LARS FARBER
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Gender | Male
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Dates
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Enumeration Date | 03/05/2019
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Last Update Date | 09/11/2023
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Provider Practice Location Address
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Address Line | 500 W ANNANDALE RD
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City | FALLS CHURCH
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State | VA
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Zip | 22046-4205
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Country | US
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Telephone | 703-521-6662
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Fax |
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Provider Business Mailing Address
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Address Line | 2151 OLD BRICK RD
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City | GLEN ALLEN
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State | VA
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Zip | 23060-5837
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Country | US
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Telephone | 516-491-6231
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0110007197
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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