Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 012464 | NY |
NPI | 1003237009 |
---|---|
Provider Name | Dr. Malorie Ann Farrell |
First Address | Waddington, NY 13694-0362 |
Second Address | Waddington, NY 13694 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/12/2013 |
Last Update Date | 16/05/2018 |