Provider Demographics
NPI:1417958612
Name:FARRAH, DAVID C (PT)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:C
Last Name:FARRAH
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:433 CASTLE SHANNON BLVD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15234-1405
Mailing Address - Country:US
Mailing Address - Phone:412-344-9044
Mailing Address - Fax:412-344-9047
Practice Address - Street 1:433 CASTLE SHANNON BLVD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15234-1405
Practice Address - Country:US
Practice Address - Phone:412-344-9044
Practice Address - Fax:412-344-9047
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT009766L174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAS77665Medicare UPIN
PA040885Medicare ID - Type Unspecified