Provider Demographics
NPI:1457931412
Name:FARRELL, EMILY
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:FARRELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:736 CAMBRIDGE STREET
Mailing Address - Street 2:ST. ELIZABETH'S MEDICAL CENTER BONE AND JOINT CENTER
Mailing Address - City:BRIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135
Mailing Address - Country:US
Mailing Address - Phone:617-779-6500
Mailing Address - Fax:
Practice Address - Street 1:736 CAMBRIDGE STREET
Practice Address - Street 2:ST. ELIZABETH'S MEDICAL CENTER BONE AND JOINT CENTER
Practice Address - City:BRIGHTON
Practice Address - State:MA
Practice Address - Zip Code:02135
Practice Address - Country:US
Practice Address - Phone:617-779-6500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-13
Last Update Date:2021-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPA8254363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant