Provider Demographics
NPI:1609679208
Name:FARRELL, SEAN PATRICK (MD)
Entity type:Individual
Prefix:
First Name:SEAN
Middle Name:PATRICK
Last Name:FARRELL
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 WASHINGTON PL
Mailing Address - Street 2:
Mailing Address - City:WEST ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11795-1826
Mailing Address - Country:US
Mailing Address - Phone:631-889-3145
Mailing Address - Fax:
Practice Address - Street 1:1 HEROES WAY
Practice Address - Street 2:
Practice Address - City:RIVERHEAD
Practice Address - State:NY
Practice Address - Zip Code:11901-2058
Practice Address - Country:US
Practice Address - Phone:631-548-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-29
Last Update Date:2025-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program