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General NPI Number Information
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NPI Number | 1871777441
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Entity Type | Organization
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Legal Business Name | MICHAEL FARRELL INC.
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Dates
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Enumeration Date | 12/19/2007
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Last Update Date | 12/19/2007
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Provider Practice Location Address
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Address Line | 44 PEARL ST W 44 PEARL STREET
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City | SIDNEY
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State | NY
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Zip | 13838-1325
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Country | US
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Telephone | 607-563-8167
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 436 44 PEARL STREET
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City | SIDNEY
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State | NY
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Zip | 13838-0436
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Country | US
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Telephone | 607-563-8167
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. MICHAEL D FARRELL
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Credential | DPM
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Telephone | 607-563-8167
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213EP1101X
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Taxonomy Name | Primary Podiatric Medicine Podiatrist
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License Number | N004551
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License Number State | NY
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