Individual
PHILLIS B FARRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
117 NORTH MECHANIC STREET, CARTHAGE, NY 13619
(315) 493-3100
(315) 493-3113
Mailing address
117 NORTH MECHANIC STREET, CARTHAGE, NY 13619
(315) 493-3100
(315) 493-3113
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
F302902-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
362748
MVP
NY
01
—
403888001
BSNENY
NY
Enumeration date
10/14/2005
Last updated
06/11/2013
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