Provider Demographics
NPI:1225399355
Name:FURNELL, JOANNE KATHRYN (MSED)
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:KATHRYN
Last Name:FURNELL
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 CRESTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SHIRLEY
Mailing Address - State:NY
Mailing Address - Zip Code:11967-1329
Mailing Address - Country:US
Mailing Address - Phone:631-772-2690
Mailing Address - Fax:
Practice Address - Street 1:214 CRESTWOOD DR
Practice Address - Street 2:
Practice Address - City:SHIRLEY
Practice Address - State:NY
Practice Address - Zip Code:11967-1329
Practice Address - Country:US
Practice Address - Phone:631-772-2690
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-05
Last Update Date:2012-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist