Provider Demographics
NPI:1578885984
Name:DUNCAN, FARREL GABRIELLE (LAC)
Entity Type:Individual
Prefix:MS
First Name:FARREL
Middle Name:GABRIELLE
Last Name:DUNCAN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:FARREL
Other - Middle Name:GABRIELLE
Other - Last Name:DUNCAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LAC
Mailing Address - Street 1:799 BROADWAY
Mailing Address - Street 2:SUITE 609
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-3209
Mailing Address - Country:US
Mailing Address - Phone:917-523-4374
Mailing Address - Fax:
Practice Address - Street 1:799 BROADWAY
Practice Address - Street 2:609
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003
Practice Address - Country:US
Practice Address - Phone:917-523-4374
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-26
Last Update Date:2015-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004306171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist