Individual
DR. LAURIE ANN FARRICIELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4212 N 16TH ST, PHOENIX, AZ 85016-5319
(602) 263-1200
(602) 263-1631
Mailing address
PO BOX 31001, PASADENA, CA 91110-0698
(602) 263-1200
(602) 263-1631
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
21865
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
172370-19
—
AZ
Enumeration date
09/20/2005
Last updated
05/07/2019
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