Provider Demographics
NPI:1326393539
Name:FARRES, NATALIA
Entity Type:Individual
Prefix:MISS
First Name:NATALIA
Middle Name:
Last Name:FARRES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:83 COATES AVE N
Mailing Address - Street 2:
Mailing Address - City:HOLBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11741-1209
Mailing Address - Country:US
Mailing Address - Phone:631-553-6704
Mailing Address - Fax:
Practice Address - Street 1:8 SWENSON DR
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:NY
Practice Address - Zip Code:11797-1223
Practice Address - Country:US
Practice Address - Phone:516-921-5292
Practice Address - Fax:516-921-5273
Is Sole Proprietor?:No
Enumeration Date:2012-07-13
Last Update Date:2012-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No171M00000XOther Service ProvidersCase Manager/Care Coordinator