Provider Demographics
NPI:1982111688
Name:HATEM, FARRAH RENATE
Entity Type:Individual
Prefix:
First Name:FARRAH
Middle Name:RENATE
Last Name:HATEM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 SOPHIA ST
Mailing Address - Street 2:
Mailing Address - City:MAMARONECK
Mailing Address - State:NY
Mailing Address - Zip Code:10543-4118
Mailing Address - Country:US
Mailing Address - Phone:914-661-7424
Mailing Address - Fax:914-630-2752
Practice Address - Street 1:MAMARONECK COMMUNITY NURSERY SCHOOL
Practice Address - Street 2:500 TOMKINS AVE
Practice Address - City:MAMARONECK
Practice Address - State:NY
Practice Address - Zip Code:10543
Practice Address - Country:US
Practice Address - Phone:914-777-1860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-03
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist