Provider Demographics
NPI:1497052112
Name:GEORGE Z. FARION M.D.P.A.
Entity Type:Organization
Organization Name:GEORGE Z. FARION M.D.P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:ZENON
Authorized Official - Last Name:FARION
Authorized Official - Suffix:
Authorized Official - Credentials:MDPA
Authorized Official - Phone:973-542-0800
Mailing Address - Street 1:87 FRANKLIN AVE
Mailing Address - Street 2:87 FRANKLIN AVENUE
Mailing Address - City:NUTLEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07110-3234
Mailing Address - Country:US
Mailing Address - Phone:973-542-0800
Mailing Address - Fax:973-542-0133
Practice Address - Street 1:87 FRANKLIN AVE
Practice Address - Street 2:87 FRANKLIN AVENUE
Practice Address - City:NUTLEY
Practice Address - State:NJ
Practice Address - Zip Code:07110-3234
Practice Address - Country:US
Practice Address - Phone:973-542-0800
Practice Address - Fax:973-542-0133
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-15
Last Update Date:2011-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03632800261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ173740Medicare UPIN