Provider Demographics
NPI:1356687982
Name:FARRELL, MARLA CREA (MD)
Entity Type:Individual
Prefix:DR
First Name:MARLA
Middle Name:CREA
Last Name:FARRELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1710 MULBERRY ST
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18510-2336
Mailing Address - Country:US
Mailing Address - Phone:570-969-7313
Mailing Address - Fax:570-969-7387
Practice Address - Street 1:1710 MULBERRY ST
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18510-2336
Practice Address - Country:US
Practice Address - Phone:570-969-7313
Practice Address - Fax:570-969-7387
Is Sole Proprietor?:No
Enumeration Date:2012-12-31
Last Update Date:2012-12-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD053382L208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics