Provider Demographics
NPI:1043555873
Name:FARRELL, MAGDALENA BARBARA (MED)
Entity type:Individual
Prefix:MRS
First Name:MAGDALENA
Middle Name:BARBARA
Last Name:FARRELL
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:83 ENNIS RD
Mailing Address - Street 2:
Mailing Address - City:NORTH OXFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01537-1202
Mailing Address - Country:US
Mailing Address - Phone:508-717-9661
Mailing Address - Fax:
Practice Address - Street 1:215 LAKE ST
Practice Address - Street 2:
Practice Address - City:SHREWSBURY
Practice Address - State:MA
Practice Address - Zip Code:01545
Practice Address - Country:US
Practice Address - Phone:508-845-8466
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-05
Last Update Date:2012-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker