MEDICARE: DR. CHRISTINE FARRELL-RILEY MD

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
1	207Q00000X	Family Medicine Physician	150187	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1992791883
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTINE FARRELL-RILEY MD

Provider Business Mailing Address
First Line	:	637 WASHINGTON ST
Second Line	:
City	:	DORCHESTER
State	:	MA
Zip	:	02124-3510
Country	:	US
Telephone Number	:	617-825-9660
Fax Number	:	617-288-7898

Provider Business Practice Location Address
First Line	:	637 WASHINGTON ST
Second Line	:
City	:	DORCHESTER
State	:	MA
Zip	:	02124-3510
Country	:	US
Telephone Number	:	617-825-9660
Fax Number	:	617-288-7898

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/26/2005
Last Update Date	:	11/17/2023

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