Basic Information
| Provider Information | |||||||||
| NPI: | 1376031047 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FARNHAM | ||||||||
| FirstName: | ANA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 160 HOLSAPPLE RD LOT 204 | ||||||||
| Address2: | |||||||||
| City: | DOVER PLAINS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 125229671 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8458770721 | ||||||||
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| Practice Location | |||||||||
| Address1: | 20 OLD NYACK TPKE | ||||||||
| Address2: | |||||||||
| City: | NANUET | ||||||||
| State: | NY | ||||||||
| PostalCode: | 109542532 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8456240260 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/27/2018 | ||||||||
| LastUpdateDate: | 04/27/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 164W00000X | 9277307 | NY | Y | Nursing Service Providers | Licensed Practical Nurse |
No ID Information.