Provider Demographics
NPI:1710069968
Name:FARKAS, DANIEL (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:FARKAS
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 1:1650 SELWYN AVE
Mailing Address - Street 2:SUITE 4E
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10457-7688
Mailing Address - Country:US
Mailing Address - Phone:718-960-1243
Mailing Address - Fax:718-960-1369
Practice Address - Street 1:1650 SELWYN AVE
Practice Address - Street 2:SUITE 4E
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-7688
Practice Address - Country:US
Practice Address - Phone:718-960-1243
Practice Address - Fax:718-960-1369
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2009-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY231580208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02729679Medicaid
NY02729679Medicaid
NY537H41Medicare PIN