Healthcare Provider Details

I. General information

NPI: 1952492480
Provider Name (Legal Business Name): DAVID LAWRENCE FARRINGTON PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 09/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

82 NEW PARK AVE
NORTH FRANKLIN CT
06254-1807
US

IV. Provider business mailing address

428 HARTFORD TURNPIKE SUITE 210
VERNON CT
06066-4877
US

V. Phone/Fax

Practice location:
  • Phone: 860-889-7345
  • Fax: 860-823-2940
Mailing address:
  • Phone: 860-872-3717
  • Fax: 860-875-2690

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number001553
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: