Individual
CORMAC FARRELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3400 SPRUCE ST, GROUND FLOOR DULLES, PHILADELPHIA, PA 19104-4206
(215) 662-3005
Mailing address
51 N. 39TH STREET, PHILADELPHIA, PA 19104-2614
(215) 662-8000
(215) 662-7011
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
MD440265
PA
2085R0204X
Vascular & Interventional Radiology Physician
Primary
MD440265
PA
Other
Enumeration date
06/23/2010
Last updated
10/10/2012
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