Individual
DEANNA L. FARRAUTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.C.
Contact information
Practice address
1600 HADDON AVE, CAMDEN, NJ 08103-3101
(856) 757-3500
Mailing address
22 THREADLEAF TER, BURLINGTON, NJ 08016-4348
(609) 531-6519
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
25MP001839
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25MP001839
MEDICAL LICENSE
NJ
Enumeration date
10/01/2008
Last updated
05/03/2010
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