Basic Information
| Provider Information | |||||||||
| NPI: | 1205924248 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FARKAS | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | J | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1130 MCBRIDE AVE FL 3 | ||||||||
| Address2: | |||||||||
| City: | WOODLAND PARK | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 074243806 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9737852277 | ||||||||
| FaxNumber: | 9737852355 | ||||||||
| Practice Location | |||||||||
| Address1: | 842 CLIFTON AVE STE 6 | ||||||||
| Address2: | |||||||||
| City: | CLIFTON | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 070131800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9737775717 | ||||||||
| FaxNumber: | 2016324815 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/11/2006 | ||||||||
| LastUpdateDate: | 12/13/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0100X | MA48276 | NJ | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
ID Information
| ID | Type | State | Issuer | Description | 0554214 | 01 | NJ | GHI PPO | OTHER | 5V9731 | 01 | NJ | BC BS OF NY 716 BROAD ST. | OTHER | 0115607000 | 01 | NJ | AMERIHEALTH | OTHER | 1694804 | 05 | NJ | MEDICAID | 3K8631 | 01 | NJ | HEALTHNET | OTHER | 398180 | 01 | NJ | WELLCARE | OTHER | 5V9732 | 01 | NJ | BC BS OF NJ SUITE 102 W. PATERSON | OTHER | P3929819 | 01 | NJ | OXFORD | OTHER |