Provider Demographics
NPI:1114267929
Name:JEFFREY FARKAS MD LLC
Entity Type:Organization
Organization Name:JEFFREY FARKAS MD LLC
Other - Org Name:INTERVENTIONAL NEURO ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:FARKAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-387-1957
Mailing Address - Street 1:43 WESTMINSTER AVE
Mailing Address - Street 2:
Mailing Address - City:BERGENFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07621-3913
Mailing Address - Country:US
Mailing Address - Phone:201-387-1957
Mailing Address - Fax:201-351-0656
Practice Address - Street 1:2200 NORTHERN BLVD
Practice Address - Street 2:SUITE 207
Practice Address - City:EAST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11548-1220
Practice Address - Country:US
Practice Address - Phone:516-466-1029
Practice Address - Fax:201-351-4065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-15
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1922302085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03563191Medicaid
NYA100083022Medicare PIN