Basic Information
| Provider Information | |||||||||
| NPI: | 1003846502 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FARBER | ||||||||
| FirstName: | LEONARD | ||||||||
| MiddleName: | RAYMOND | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 333 CEDAR STREET, FMP 113 | ||||||||
| Address2: | |||||||||
| City: | NEW HAVEN | ||||||||
| State: | CT | ||||||||
| PostalCode: | 06520 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2037854191 | ||||||||
| FaxNumber: | 2037853788 | ||||||||
| Practice Location | |||||||||
| Address1: | 333 CEDAR ST., FMP 113 | ||||||||
| Address2: | |||||||||
| City: | NEW HAVEN | ||||||||
| State: | CT | ||||||||
| PostalCode: | 06520 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2037854191 | ||||||||
| FaxNumber: | 2037853788 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/03/2006 | ||||||||
| LastUpdateDate: | 01/31/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RH0003X | 14821 | CT | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology |
No ID Information.