Provider Demographics
NPI:1043765589
Name:FARQUHARSON, ANGELLAE (RN)
Entity type:Individual
Prefix:MS
First Name:ANGELLAE
Middle Name:
Last Name:FARQUHARSON
Suffix:
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:162 COMMONWEALTH AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10552-2017
Mailing Address - Country:US
Mailing Address - Phone:914-202-5876
Mailing Address - Fax:
Practice Address - Street 1:162 COMMONWEALTH AVE
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10552-2017
Practice Address - Country:US
Practice Address - Phone:914-202-5876
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-24
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY323606164W00000X
NY816907163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No164W00000XNursing Service ProvidersLicensed Practical Nurse