Provider Demographics
NPI:1275912008
Name:FARR, MICHAEL THOMAS (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:THOMAS
Last Name:FARR
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 1:70 E FRONT ST FL 5
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-1851
Mailing Address - Country:US
Mailing Address - Phone:732-450-1200
Mailing Address - Fax:732-450-1220
Practice Address - Street 1:70 E FRONT ST FL 5
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-1851
Practice Address - Country:US
Practice Address - Phone:732-450-1200
Practice Address - Fax:732-450-1220
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-26
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA10803800208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty