Provider Demographics
NPI:1093981425
Name:FARRIS, GRACE E (MD)
Entity Type:Individual
Prefix:DR
First Name:GRACE
Middle Name:E
Last Name:FARRIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 AMSTERDAM AVE
Mailing Address - Street 2:CLARK 7
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-1716
Mailing Address - Country:US
Mailing Address - Phone:212-523-5918
Mailing Address - Fax:212-523-2842
Practice Address - Street 1:1111 AMSTERDAM AVE
Practice Address - Street 2:CLARK 7
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-1716
Practice Address - Country:US
Practice Address - Phone:212-523-5918
Practice Address - Fax:212-523-2842
Is Sole Proprietor?:No
Enumeration Date:2008-05-06
Last Update Date:2019-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY286724208M00000X
MA249078208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist