Basic Information
| Provider Information | |||||||||
| NPI: | 1255381067 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FARINA | ||||||||
| FirstName: | ALEXANDER | ||||||||
| MiddleName: | JOSEPH | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 445 WHITEHORSE AVE | ||||||||
| Address2: | SUITE 202 | ||||||||
| City: | HAMILTON | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 086101410 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6095851122 | ||||||||
| FaxNumber: | 6095850309 | ||||||||
| Practice Location | |||||||||
| Address1: | 445 WHITEHORSE AVE | ||||||||
| Address2: | SUITE 202 | ||||||||
| City: | HAMILTON | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 086101410 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6095851122 | ||||||||
| FaxNumber: | 6095850309 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/11/2006 | ||||||||
| LastUpdateDate: | 04/15/2011 | ||||||||
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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 | 207Q00000X | 25MB02043600 | NJ | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 1679503 | 05 | NJ | MEDICAID |