Provider Demographics
NPI:1356723688
Name:GOLDFARB, LUANN (RRT)
Entity type:Individual
Prefix:
First Name:LUANN
Middle Name:
Last Name:GOLDFARB
Suffix:
Gender:F
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 GLADE CIR E
Mailing Address - Street 2:
Mailing Address - City:REHOBOTH BEACH
Mailing Address - State:DE
Mailing Address - Zip Code:19971-4140
Mailing Address - Country:US
Mailing Address - Phone:302-227-2803
Mailing Address - Fax:
Practice Address - Street 1:26351 PATRIOTS WAY
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:DE
Practice Address - Zip Code:19947-2575
Practice Address - Country:US
Practice Address - Phone:302-933-3000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-23
Last Update Date:2015-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC9-0000738227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered