Basic Information
Provider Information
NPI: 1033557061
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FARBER
FirstName: BRITTANY
MiddleName: ANN
NamePrefix: DR.
NameSuffix:  
Credential: DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2660 W MARKET ST
Address2: SUITE 300
City: FAIRLAWN
State: OH
PostalCode: 443334208
CountryCode: US
TelephoneNumber: 3308692635
FaxNumber: 3308698315
Practice Location
Address1: 2660 W MARKET ST
Address2: SUITE 300
City: FAIRLAWN
State: OH
PostalCode: 443334208
CountryCode: US
TelephoneNumber: 3308692635
FaxNumber: 3308698315
Other Information
ProviderEnumerationDate: 06/12/2013
LastUpdateDate: 09/30/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
261QP2000X014277OHY Ambulatory Health Care FacilitiesClinic/CenterPhysical Therapy

No ID Information.


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