Provider Demographics
NPI:1306155478
Name:FARKAS, HEATHER L (PT)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:L
Last Name:FARKAS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 HALL PL
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:DE
Mailing Address - Zip Code:19963-1809
Mailing Address - Country:US
Mailing Address - Phone:302-396-0473
Mailing Address - Fax:302-258-1853
Practice Address - Street 1:300 HALL PL
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:DE
Practice Address - Zip Code:19963-1809
Practice Address - Country:US
Practice Address - Phone:302-396-0473
Practice Address - Fax:302-258-1853
Is Sole Proprietor?:No
Enumeration Date:2010-10-06
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023291-1225100000X
DEJ1-0002729225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist