Provider Demographics
NPI:1114902848
Name:FARB, PERRY G (DO)
Entity Type:Individual
Prefix:
First Name:PERRY
Middle Name:G
Last Name:FARB
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Gender:M
Credentials:DO
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Mailing Address - Street 1:1 MONARCH PL
Mailing Address - Street 2:10TH FLOOR
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01144-1099
Mailing Address - Country:US
Mailing Address - Phone:413-734-2000
Mailing Address - Fax:413-734-8000
Practice Address - Street 1:1 MONARCH PL
Practice Address - Street 2:10TH FLOOR
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01144-1099
Practice Address - Country:US
Practice Address - Phone:413-734-2000
Practice Address - Fax:413-734-8000
Is Sole Proprietor?:No
Enumeration Date:2005-12-15
Last Update Date:2014-11-25
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Provider Licenses
StateLicense IDTaxonomies
MA224137207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
A38455OtherMEDICARE B
AA37972OtherHARVARD PILGRIM
042472266OtherUNITED HEALTHCARE
042472266OtherTRICARE CHAMPUS
042472266OtherPRIVATE HEALTHCARE
38788OtherFIRST HEALTH
J29464OtherBLUE CARE ELECT
042472266OtherONE HEALTH PLAN
MA2106329Medicaid
305217OtherTUFTS HEALTH PLAN
4025035OtherCIGNA HEALTHSOURCE
4113555OtherAETNA US HEALTHCARE
92432OtherFALLON COMMUNITY HEALTH
J29464OtherBLUE CARE ELECT