Provider Demographics
NPI:1922051549
Name:FARLEY, PATRICK H (PA)
Entity Type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:H
Last Name:FARLEY
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2730 UNIVERSITY BLVD W
Mailing Address - Street 2:STE 310
Mailing Address - City:WHEATON
Mailing Address - State:MD
Mailing Address - Zip Code:20902-1990
Mailing Address - Country:US
Mailing Address - Phone:301-942-7600
Mailing Address - Fax:301-942-3132
Practice Address - Street 1:2730 UNIVERSITY BLVD W STE 310
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:MD
Practice Address - Zip Code:20902-1990
Practice Address - Country:US
Practice Address - Phone:301-942-7600
Practice Address - Fax:301-942-3132
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0003354363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYPA1173Medicare PIN
NYQ58412Medicare UPIN