Provider Demographics
NPI:1649398884
Name:FARRELL, CHRISTINA M (DPM)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:M
Last Name:FARRELL
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:933 N CHARLOTTE ST
Mailing Address - Street 2:SUITE 2C
Mailing Address - City:POTTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19464-3974
Mailing Address - Country:US
Mailing Address - Phone:610-326-4367
Mailing Address - Fax:
Practice Address - Street 1:933 N CHARLOTTE ST
Practice Address - Street 2:SUITE 2C
Practice Address - City:POTTSTOWN
Practice Address - State:PA
Practice Address - Zip Code:19464-3974
Practice Address - Country:US
Practice Address - Phone:610-326-4367
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2012-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC004105L213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA07157388Medicaid
PAU58526Medicare UPIN
PA07157388Medicaid