Provider Demographics
NPI:1346509585
Name:FARKAS, RACHEL E (RN)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:E
Last Name:FARKAS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1334 CAFFREY AVE
Mailing Address - Street 2:APT 4C
Mailing Address - City:FAR ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11691
Mailing Address - Country:US
Mailing Address - Phone:614-581-7610
Mailing Address - Fax:
Practice Address - Street 1:475 W 186TH ST
Practice Address - Street 2:APT 5F
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033-2903
Practice Address - Country:US
Practice Address - Phone:614-581-7610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-09
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY645160163W00000X
NJ26NR15989300163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYPT53548DMedicaid