Provider Demographics
NPI:1730269994
Name:FARNESE, JEFFREY JASON (MD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:JASON
Last Name:FARNESE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 NEWARK POMPTON TPKE
Mailing Address - Street 2:
Mailing Address - City:LITTLE FALLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07424
Mailing Address - Country:US
Mailing Address - Phone:973-890-0330
Mailing Address - Fax:973-890-0705
Practice Address - Street 1:109 NEWARK POMPTON TPKE
Practice Address - Street 2:
Practice Address - City:LITTLE FALLS
Practice Address - State:NJ
Practice Address - Zip Code:07424
Practice Address - Country:US
Practice Address - Phone:973-890-0330
Practice Address - Fax:973-890-0705
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA69444207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ027676Medicare PIN
NJG94426Medicare UPIN