Provider Demographics
NPI:1114997012
Name:FARRER, WILLIAM (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:FARRER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 WILLIAMSON ST STE 401
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH
Mailing Address - State:NJ
Mailing Address - Zip Code:07202-3672
Mailing Address - Country:US
Mailing Address - Phone:908-282-0500
Mailing Address - Fax:908-282-1482
Practice Address - Street 1:240 WILLIAMSON ST STE 401
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07202-3672
Practice Address - Country:US
Practice Address - Phone:908-282-0500
Practice Address - Fax:908-282-1482
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-24
Last Update Date:2019-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA37417207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1332201Medicaid
451290Medicare ID - Type Unspecified
NJ1332201Medicaid