| Brian Farran, Ph.d., Llc | |
|
111 S Orange Ave Ste 24 South Orange NJ 07079-1931 | |
| (973) 327-4393 | |
| (973) 352-6578 |
| Full Name | Brian Farran, Ph.d., Llc |
|---|---|
| Speciality | Psychologist |
| Location | 111 S Orange Ave Ste 24, South Orange, New Jersey |
| Authorized Official Name and Position | Brian Farran (CLINICAL PSYCHOLOGIST / CEO) |
| Authorized Official Contact | 9733274393 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brian Farran, Ph.d., Llc 609 W South Orange Ave Apt 5r South Orange NJ 07079-1066 Ph: (973) 327-4393 | Brian Farran, Ph.d., Llc 111 S Orange Ave Ste 24 South Orange NJ 07079-1931 Ph: (973) 327-4393 |
| NPI Number | 1619112935 |
|---|---|
| Provider Enumeration Date | 12/16/2008 |
| Last Update Date | 11/20/2020 |
| Certification Date | 11/20/2020 |
| Medicare PECOS PAC ID | 1456531599 |
|---|---|
| Medicare Enrollment ID | O20110208000170 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619112935 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Brian Farran |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1396721239 PECOS PAC ID: 7315968500 Enrollment ID: I20070828000710 |
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