Individual
MS. LISA FARRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
15 MODEL CT, ROCKY POINT, NY 11778-8815
(631) 821-3512
Mailing address
15 MODEL CT, ROCKY POINT, NY 11778-8815
(631) 821-3512
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
542404-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01525855
—
NY
Enumeration date
09/07/2007
Last updated
09/07/2007
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