Individual
JOHN MARK FARRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
900 NORTHROP RD, WALLINGFORD, CT 06492
(203) 949-1534
Mailing address
900 NORTHROP RD, WALLINGFORD, CT 06492-1997
(203) 949-1534
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
000202
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003002029
—
CT
Enumeration date
03/22/2007
Last updated
10/10/2016
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