Individual
NICHOLAS ADAM FARACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1800 ORLEANS ST, BALTIMORE, MD 21287-0010
(314) 599-3696
Mailing address
6201 GREENLEIGH AVE, MIDDLE RIVER, MD 21220-2004
(410) 933-6421
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C0008098
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C08098
LICENSE
MD
Enumeration date
01/27/2020
Last updated
09/20/2021
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