Provider Demographics
NPI:1235374166
Name:FARRELL, JOSEPH CONCODORA (PHARMD, RPH)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:CONCODORA
Last Name:FARRELL
Suffix:
Gender:M
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 CRESTWOOD LN
Mailing Address - Street 2:
Mailing Address - City:DELMAR
Mailing Address - State:NY
Mailing Address - Zip Code:12054-1604
Mailing Address - Country:US
Mailing Address - Phone:201-306-3534
Mailing Address - Fax:
Practice Address - Street 1:1395 NEW SCOTLAND RD #176
Practice Address - Street 2:PRICE CHOPPER PHARMACY
Practice Address - City:SLINGERLANDS
Practice Address - State:NY
Practice Address - Zip Code:12159
Practice Address - Country:US
Practice Address - Phone:518-664-1112
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-05
Last Update Date:2008-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY053100-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist