Provider Demographics
NPI:1770764656
Name:FARRELL, DENIS J
Entity type:Individual
Prefix:
First Name:DENIS
Middle Name:J
Last Name:FARRELL
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 1:296 S MAIN ST
Mailing Address - Street 2:APT 7
Mailing Address - City:LIBERTY
Mailing Address - State:NY
Mailing Address - Zip Code:12754-2020
Mailing Address - Country:US
Mailing Address - Phone:845-292-6177
Mailing Address - Fax:
Practice Address - Street 1:20 COMMUNITY LN
Practice Address - Street 2:
Practice Address - City:LIBERTY
Practice Address - State:NY
Practice Address - Zip Code:12754-2851
Practice Address - Country:US
Practice Address - Phone:845-292-8770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-19
Last Update Date:2007-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker