Provider Demographics
NPI:1659674307
Name:FARRARE, EUGENE AMIR (RN, BSN)
Entity Type:Individual
Prefix:MR
First Name:EUGENE
Middle Name:AMIR
Last Name:FARRARE
Suffix:
Gender:M
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7872 W.HENRIETTA RD
Mailing Address - Street 2:
Mailing Address - City:RUSH
Mailing Address - State:NY
Mailing Address - Zip Code:14543-9412
Mailing Address - Country:US
Mailing Address - Phone:585-503-3177
Mailing Address - Fax:
Practice Address - Street 1:7872 W HENRIETTA RD
Practice Address - Street 2:
Practice Address - City:RUSH
Practice Address - State:NY
Practice Address - Zip Code:14543-9412
Practice Address - Country:US
Practice Address - Phone:585-503-3177
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-17
Last Update Date:2010-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY22606764163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse