Provider Demographics
NPI:1912592916
Name:FARR, NICHOLAS T (MS, LCAT)
Entity type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:T
Last Name:FARR
Suffix:
Gender:M
Credentials:MS, LCAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 WIRELESS BLVD STE 172
Mailing Address - Street 2:
Mailing Address - City:HAUPPAUGE
Mailing Address - State:NY
Mailing Address - Zip Code:11788-3949
Mailing Address - Country:US
Mailing Address - Phone:646-543-6005
Mailing Address - Fax:
Practice Address - Street 1:49 WIRELESS BLVD STE 172
Practice Address - Street 2:
Practice Address - City:HAUPPAUGE
Practice Address - State:NY
Practice Address - Zip Code:11788-3949
Practice Address - Country:US
Practice Address - Phone:646-543-6005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-02
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002477-01225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist