Provider Demographics
NPI:1558420364
Name:FARION, GEORGE ZENON (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:ZENON
Last Name:FARION
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 1:87 FRANKLIN AVE
Mailing Address - Street 2:
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:
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
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA36328207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3631907Medicaid
NJ3631907Medicaid
NJFA173740Medicare ID - Type Unspecified