MEDICARE: BARRY M. FARBER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	MD012388E	PA

General Provider Information

NPI Number	:	1164468369
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARRY M. FARBER MD

Provider Business Mailing Address
First Line	:	101 E OLNEY AVE
Second Line	:	SUITE 400
City	:	PHILADELPHIA
State	:	PA
Zip	:	19120-2421
Country	:	US
Telephone Number	:	215-456-7000
Fax Number	:	215-254-2599

Provider Business Practice Location Address
First Line	:	4200 MONUMENT RD
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19131-1625
Country	:	US
Telephone Number	:	215-581-3736
Fax Number	:	215-254-2599

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2006
Last Update Date	:	07/08/2007

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