Healthcare Provider Details

I. General information

NPI: 1972039360
Provider Name (Legal Business Name): MATTHEW ANTHONY FARRAYE PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2017
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 POND PARK RD STE 102
HINGHAM MA
02043-4354
US

IV. Provider business mailing address

2 POND PARK RD STE 102
HINGHAM MA
02043-4354
US

V. Phone/Fax

Practice location:
  • Phone: 781-337-5555
  • Fax: 781-335-6047
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA6097
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: