Provider Demographics
NPI:1639473812
Name:FARKAS, BENJAMIN A (DC)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:A
Last Name:FARKAS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8400 BUSTLETON AVE STE 7
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19152-1918
Mailing Address - Country:US
Mailing Address - Phone:215-464-1680
Mailing Address - Fax:
Practice Address - Street 1:841 E ALLEGHENY AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19134-2401
Practice Address - Country:US
Practice Address - Phone:215-425-1500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-03
Last Update Date:2021-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX0073741111N00000X
NJ38MC00445500111N00000X
PADC010021111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYU48367Medicare UPIN