Provider Demographics
NPI:1619112935
Name:BRIAN FARRAN, PH.D., LLC
Entity Type:Organization
Organization Name:BRIAN FARRAN, PH.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST / CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:FARRAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:973-327-4393
Mailing Address - Street 1:609 W SOUTH ORANGE AVE APT 5R
Mailing Address - Street 2:
Mailing Address - City:SOUTH ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07079-1066
Mailing Address - Country:US
Mailing Address - Phone:973-327-4393
Mailing Address - Fax:973-352-6578
Practice Address - Street 1:111 S ORANGE AVE STE 24
Practice Address - Street 2:
Practice Address - City:SOUTH ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07079-1931
Practice Address - Country:US
Practice Address - Phone:973-327-4393
Practice Address - Fax:973-352-6578
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-16
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty