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NPI Code Detail

MEDICARE: MARYANNE R FARINA PA

MEDICARE: MARYANNE R FARINA PA
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
1363AM0700XMedical Physician Assistant000887CT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1952411936
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARYANNE R FARINA PA
Provider Business Mailing Address
First Line : 100 PATRIOTS RD
Second Line :
City : STONY BROOK
State : NY
Zip : 11790-3318
Country : US
Telephone Number : 631-444-8608
Fax Number : 631-444-8778
Provider Business Practice Location Address
First Line : 100 PATRIOTS RD
Second Line :
City : STONY BROOK
State : NY
Zip : 11790-3318
Country : US
Telephone Number : 631-444-8608
Fax Number : 631-444-8778
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2006
Last Update Date : 12/27/2019

Similar Medicare Providers

1184621724 — STATE OF NEW YORK COMPTROLLERS OFFICE
Practice Location Address:
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1659317741 — STATE OF NEW YORK COMPTROLLERS OFFICE
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1326123886 — DR. CARLOS FERMO JR. MD
Practice Location Address:
100 PATRIOTS RD
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11790-3318
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1730264441 — DR. MOHAMMED JAHANGIR ALAM M.D.
Practice Location Address:
100 PATRIOTS RD
STONY BROOK, NY
11790-3318
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1891853438 — MS. REBECCA M LEONG RPH
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11790-3318
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Directions to “ MARYANNE R FARINA PA” Practice Location

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