Provider Demographics
NPI:1285720789
Name:FARKAS, DANIEL (OD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:FARKAS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 SUFFOLK AVE
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11717
Mailing Address - Country:US
Mailing Address - Phone:631-231-4455
Mailing Address - Fax:631-434-1728
Practice Address - Street 1:601 SUFFOLK AVE
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:NY
Practice Address - Zip Code:11717
Practice Address - Country:US
Practice Address - Phone:631-231-4455
Practice Address - Fax:631-434-1728
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2012-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004995152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY6500355OtherGHI PPO
NY01950054Medicaid
NY112355523OtherTAX ID#
NY112355523OtherHORIZON HEALTH
NYC69141OtherB/C B/S
NY4277432OtherAETNA PPO
NY4C6490OtherHEALTHNET
NY37506POtherHIP
NY112355523OtherFIRST HEALTH
NY2300056OtherAETNA HMO
NYP1256155OtherOXFORD
NYC69141OtherB/C B/S
NY01950054Medicaid