MEDICARE: JAMES FARREN DC

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	111N00000X	Chiropractor	X010936	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	JF0X7S4710	OTHER	NY	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1558393165
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES FARREN DC

Provider Business Mailing Address
First Line	:	30 STRYKER ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11223-5223
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	139 FULTON ST RM 700
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10038-2533
Country	:	US
Telephone Number	:	212-406-0134
Fax Number	:

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

Provider Enumeration Date	:	07/06/2006
Last Update Date	:	05/12/2008

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Directions to “ JAMES FARREN DC” Practice Location

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