Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | 227164 | NY |
NPI | 1134344138 |
---|---|
Provider Name | Ms. Paula Ann Farrell |
First Address | Syracuse, NY 13210-1687 |
Second Address | Johnson City, NY 13790-2107 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2007 |
Last Update Date | 22/12/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02721786 | (05) | NY |