Healthcare Provider Details

I. General information

NPI: 1174614622
Provider Name (Legal Business Name): ESTELLE R FARRELL DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ESTELLE FARRELL-NIERENBERG DO

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 11/11/2022
Certification Date: 01/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4921 E BELL RD STE 203
SCOTTSDALE AZ
85254-6002
US

IV. Provider business mailing address

13835 N TATUM BLVD STE 9236
PHOENIX AZ
85032-0405
US

V. Phone/Fax

Practice location:
  • Phone: 480-955-1515
  • Fax: 844-287-5554
Mailing address:
  • Phone: 480-209-4554
  • Fax: 844-287-5554

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number3223
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number3223
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: