Provider Demographics
NPI:1881866515
Name:ALAN FARBER
Entity Type:Organization
Organization Name:ALAN FARBER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:FARBER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:212-840-1985
Mailing Address - Street 1:1501 BROADWAY
Mailing Address - Street 2:ROOM 520
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10036-5505
Mailing Address - Country:US
Mailing Address - Phone:212-840-1985
Mailing Address - Fax:212-840-7856
Practice Address - Street 1:1501 BROADWAY
Practice Address - Street 2:ROOM 520
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10036-5505
Practice Address - Country:US
Practice Address - Phone:212-840-1985
Practice Address - Fax:212-840-7856
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-02
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002362213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00413492Medicaid
NY00413492Medicaid
NY0491950001Medicare NSC
NYP26341Medicare PIN