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NPI Code Detail

MEDICARE: WENDY FARRAR RN, NP, -C, MS

MEDICARE: WENDY FARRAR RN, NP, -C, MS
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
1363LX0001XObstetrics & Gynecology Nurse PractitionerF360076-1NY
2363L00000XNurse PractitionerF360076-1NY

General Provider Information

NPI Number : 1891859567
Entity Type Code : Individual
Provider Name (Legal Business Name) : WENDY FARRAR RN, NP, -C, MS
Provider Business Mailing Address
First Line : 900 MERCHANTS CONCOURSE STE 216
Second Line :
City : WESTBURY
State : NY
Zip : 11590-5114
Country : US
Telephone Number : 516-226-8373
Fax Number :
Provider Business Practice Location Address
First Line : 12 MEDICAL DR
Second Line :
City : PORT JEFFERSON STATION
State : NY
Zip : 11776-1588
Country : US
Telephone Number : 631-331-4400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/20/2006
Last Update Date : 12/03/2019

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