Provider Demographics
NPI:1952492480
Name:FARRINGTON, DAVID LAWRENCE (PA)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:LAWRENCE
Last Name:FARRINGTON
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:428 HARTFORD TURNPIKE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:VERNON
Mailing Address - State:CT
Mailing Address - Zip Code:06066-4877
Mailing Address - Country:US
Mailing Address - Phone:860-872-3717
Mailing Address - Fax:860-875-2690
Practice Address - Street 1:82 NEW PARK AVE
Practice Address - Street 2:
Practice Address - City:NORTH FRANKLIN
Practice Address - State:CT
Practice Address - Zip Code:06254-1807
Practice Address - Country:US
Practice Address - Phone:860-889-7345
Practice Address - Fax:860-823-2940
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2010-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001553363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT508841OtherCONNECTICARE
CT2V5428OtherHEALTH NET
CT290001553CT01OtherBC/BS OF CONNECTICUT
CT5F4221Medicare UPIN
CT2V5428OtherHEALTH NET