Provider Demographics
NPI:1740276393
Name:FARBOWITZ, MICHAEL A (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:A
Last Name:FARBOWITZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:551 MILLBURN AVE
Mailing Address - Street 2:
Mailing Address - City:SHORT HILLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07078-3330
Mailing Address - Country:US
Mailing Address - Phone:973-379-2544
Mailing Address - Fax:973-379-1317
Practice Address - Street 1:551 MILLBURN AVE
Practice Address - Street 2:
Practice Address - City:SHORT HILLS
Practice Address - State:NJ
Practice Address - Zip Code:07078-3330
Practice Address - Country:US
Practice Address - Phone:973-379-2544
Practice Address - Fax:973-379-1317
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-20
Last Update Date:2010-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07217000207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8500002Medicaid
NJP2403344OtherOXFORD
NJ439B3OtherWELLCHOICE
NJ2065296000OtherAMERIHEALTH
NJ2K3639OtherHEALTHNET
NJ88880OtherLOCAL 825
NJP00053889OtherPALMETTO
NJ8217584OtherGHI
NJ8217584OtherGHI
NJ439B3OtherWELLCHOICE