Provider Demographics
NPI:1336343409
Name:APPELBAUM,FARKASH & WALDMAN, LLP
Entity Type:Organization
Organization Name:APPELBAUM,FARKASH & WALDMAN, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GLENN
Authorized Official - Middle Name:EVAN
Authorized Official - Last Name:WALDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-939-0800
Mailing Address - Street 1:5907 175TH PL
Mailing Address - Street 2:FIRST FLOOR
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11365-1551
Mailing Address - Country:US
Mailing Address - Phone:718-939-0800
Mailing Address - Fax:718-939-1325
Practice Address - Street 1:5907 175TH PL
Practice Address - Street 2:FIRST FLOOR
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11365-1551
Practice Address - Country:US
Practice Address - Phone:718-939-0800
Practice Address - Fax:718-939-1325
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-13
Last Update Date:2007-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01874368Medicaid
NY01874368Medicaid