Provider Demographics
NPI:1538107867
Name:FARBER, MICHAEL S (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:S
Last Name:FARBER
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 1:291 FRANKLIN AVENUE
Mailing Address - Street 2:
Mailing Address - City:WYCKOFF
Mailing Address - State:NJ
Mailing Address - Zip Code:07481-2849
Mailing Address - Country:US
Mailing Address - Phone:201-847-0119
Mailing Address - Fax:201-847-0871
Practice Address - Street 1:20 PROSPECT AVENUE
Practice Address - Street 2:
Practice Address - City:HACKENSCK
Practice Address - State:NJ
Practice Address - Zip Code:07601-2849
Practice Address - Country:US
Practice Address - Phone:201-996-3166
Practice Address - Fax:201-968-0937
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06935900207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ029595Medicare ID - Type Unspecified
H00398Medicare UPIN