Provider Demographics
NPI:1669765731
Name:FARKAS, LARRY R (DMD)
Entity type:Individual
Prefix:DR
First Name:LARRY
Middle Name:R
Last Name:FARKAS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:162 W 56TH ST STE 207
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-8010
Mailing Address - Country:US
Mailing Address - Phone:212-247-7059
Mailing Address - Fax:
Practice Address - Street 1:162 W 56TH ST STE 207
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-8010
Practice Address - Country:US
Practice Address - Phone:212-247-7059
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-24
Last Update Date:2011-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY042129122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist