Provider Demographics
NPI:1225244015
Name:RENEE CARISIO-FARBER, MD
Entity Type:Organization
Organization Name:RENEE CARISIO-FARBER, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:
Authorized Official - Last Name:CARISIO-FARBER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:540-349-7204
Mailing Address - Street 1:253 VETERANS DR
Mailing Address - Street 2:
Mailing Address - City:WARRENTON
Mailing Address - State:VA
Mailing Address - Zip Code:20186-3076
Mailing Address - Country:US
Mailing Address - Phone:540-349-7204
Mailing Address - Fax:540-349-7208
Practice Address - Street 1:253 VETERANS DR
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:VA
Practice Address - Zip Code:20186-3076
Practice Address - Country:US
Practice Address - Phone:540-349-7204
Practice Address - Fax:540-349-7208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101232018174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAH75576Medicare UPIN