Provider Demographics
NPI:1184663338
Name:GOLDFARB, RICHARD M (M D FACS LLC)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:M
Last Name:GOLDFARB
Suffix:
Gender:M
Credentials:M D FACS LLC
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:940 TOWN CENTER DR
Mailing Address - Street 2:SUITE F-20
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-1772
Mailing Address - Country:US
Mailing Address - Phone:215-702-1200
Mailing Address - Fax:215-702-1300
Practice Address - Street 1:904 TOWN CENTER DRIVE
Practice Address - Street 2:SUITE F-20
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047
Practice Address - Country:US
Practice Address - Phone:215-702-1200
Practice Address - Fax:215-702-1300
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-05
Last Update Date:2009-09-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD038006E174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1184663338Medicare Oscar/Certification
PA1740434364Medicare Oscar/Certification