Provider Demographics
NPI:1881618759
Name:FARNHAM, TAMMY LYNE (MIDWIFE)
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:LYNE
Last Name:FARNHAM
Suffix:
Gender:F
Credentials:MIDWIFE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:82 HOLLAND ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14605-2131
Mailing Address - Country:US
Mailing Address - Phone:585-423-2800
Mailing Address - Fax:585-423-0739
Practice Address - Street 1:82 HOLLAND ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14605-2131
Practice Address - Country:US
Practice Address - Phone:585-423-2800
Practice Address - Fax:585-423-0739
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1119367A00000X
NY001119367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP010101119OtherBLUE CHOICE ROCHESTER
NY001119Medicaid
NY142525CQOtherPREFERRED CARE
NY6613OtherBLUE CROSS ROCHESTER GRP
NY142525CQOtherPREFERRED CARE
NY001119Medicaid
NYRA2279Medicare PIN