Provider Demographics
NPI:1164418901
Name:FARBER, ALAN M (DPM)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:M
Last Name:FARBER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1501 BROADWAY
Mailing Address - Street 2:ROOM 520
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10036
Mailing Address - Country:US
Mailing Address - Phone:212-840-1985
Mailing Address - Fax:212-840-7856
Practice Address - Street 1:1501 BROADWAY
Practice Address - Street 2:ROOM 520
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10036
Practice Address - Country:US
Practice Address - Phone:212-840-1985
Practice Address - Fax:212-840-7856
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-27
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002362213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00413492Medicaid
NY00413492Medicaid
NYP26341Medicare PIN