Provider Demographics
NPI:1710165600
Name:FARMER, STEPHEN S (PSYCHOLOGIST)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:S
Last Name:FARMER
Suffix:
Gender:M
Credentials:PSYCHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 WESTFALL RD APT 32
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14620-4657
Mailing Address - Country:US
Mailing Address - Phone:571-294-5303
Mailing Address - Fax:
Practice Address - Street 1:420 WESTFALL RD APT 32
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620-4657
Practice Address - Country:US
Practice Address - Phone:571-294-5303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-04
Last Update Date:2016-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021329-1103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist