Provider Demographics
NPI:1821196965
Name:FARRICY, JOHN PATRICK (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:PATRICK
Last Name:FARRICY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:328 SHREWSBURY ST
Mailing Address - Street 2:STE 100
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01604-4613
Mailing Address - Country:US
Mailing Address - Phone:508-755-4861
Mailing Address - Fax:508-752-1392
Practice Address - Street 1:328 SHREWSBURY ST
Practice Address - Street 2:STE 100
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01604-4613
Practice Address - Country:US
Practice Address - Phone:508-755-4861
Practice Address - Fax:508-752-1392
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA39316207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3089550Medicaid
MAB76974Medicare UPIN
MA3089550Medicaid