Provider Demographics
NPI:1457822389
Name:DUFFY, JOHN FRANCIS
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:FRANCIS
Last Name:DUFFY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:76 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:WHITINSVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:01588-1464
Mailing Address - Country:US
Mailing Address - Phone:508-948-7812
Mailing Address - Fax:
Practice Address - Street 1:76 CHURCH ST
Practice Address - Street 2:
Practice Address - City:WHITINSVILLE
Practice Address - State:MA
Practice Address - Zip Code:01588-1464
Practice Address - Country:US
Practice Address - Phone:508-234-4181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-17
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA4913OtherIN HOME THERAPU