Provider Demographics
NPI:1073949061
Name:FARBER, ANDREA (OD)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:
Last Name:FARBER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 FAXON ST
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02458-1034
Mailing Address - Country:US
Mailing Address - Phone:508-633-0692
Mailing Address - Fax:
Practice Address - Street 1:669 MAIN ST
Practice Address - Street 2:
Practice Address - City:WAKEFIELD
Practice Address - State:MA
Practice Address - Zip Code:01880-5221
Practice Address - Country:US
Practice Address - Phone:781-245-5200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-23
Last Update Date:2018-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC4829152W00000X
MA5068152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist