Provider Demographics
NPI:1790283414
Name:FARNHAM, JOSHUA C (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:C
Last Name:FARNHAM
Suffix:
Gender:M
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5471 CARLS RD
Mailing Address - Street 2:
Mailing Address - City:CANISTEO
Mailing Address - State:NY
Mailing Address - Zip Code:14823-9417
Mailing Address - Country:US
Mailing Address - Phone:607-661-5265
Mailing Address - Fax:
Practice Address - Street 1:5471 CARLS RD
Practice Address - Street 2:
Practice Address - City:CANISTEO
Practice Address - State:NY
Practice Address - Zip Code:14823-9417
Practice Address - Country:US
Practice Address - Phone:607-661-5265
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-28
Last Update Date:2018-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY566331-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty