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NPI Code Detail

MEDICARE: COLLEEN ANN FARRELL M.D.

MEDICARE: COLLEEN ANN FARRELL M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician022648CT
2207Q00000XFamily Medicine Physician255689MA

General Provider Information

NPI Number : 1497038129
Entity Type Code : Individual
Provider Name (Legal Business Name) : COLLEEN ANN FARRELL M.D.
Provider Business Mailing Address
First Line : 1200 CENTRE ST
Second Line : DEPARTMENT OF MEDICINE
City : ROSLINDALE
State : MA
Zip : 02131-1000
Country : US
Telephone Number : 617-363-8010
Fax Number : 617-363-8929
Provider Business Practice Location Address
First Line : 1200 CENTRE ST
Second Line : DEPARTMENT OF MEDICINE
City : ROSLINDALE
State : MA
Zip : 02131-1000
Country : US
Telephone Number : 617-363-8010
Fax Number : 617-363-8929
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2011
Last Update Date : 11/16/2015

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Directions to “ COLLEEN ANN FARRELL M.D.” Practice Location

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