Provider Demographics
NPI:1588762850
Name:FARKAS, WALTER M (MD)
Entity type:Individual
Prefix:DR
First Name:WALTER
Middle Name:M
Last Name:FARKAS
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 1:2000 N VILLAGE AVE
Mailing Address - Street 2:SUITE 207
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-1078
Mailing Address - Country:US
Mailing Address - Phone:516-766-7785
Mailing Address - Fax:516-766-7797
Practice Address - Street 1:2000 N VILLAGE AVE
Practice Address - Street 2:SUITE 207
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-1078
Practice Address - Country:US
Practice Address - Phone:516-766-7785
Practice Address - Fax:516-766-7797
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY097469174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY564911Medicare ID - Type Unspecified
NYB16568Medicare UPIN