Look up the most recent NPI and PECOS records

Douglas Rudolph Farrell

Student in an Organized Health Care Education/Training Program

Student, Health Care

PECOS Enrollment

This provider is enrolled in PECOS as DOUGLAS FARRELL.

Based on the most recent information from CMS, provider Douglas Rudolph Farrell is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 6 days ago.

Profile Details

Provider ID
1184186934
Provider Type
Individual
Full Name
Farrell, Douglas Rudolph
Gender
Male

Sole Proprietor
Yes
Enumeration Date
4/2/2019
Last Updated
4/4/2019

Contact Information

Practice Location

17 E 102nd St, New York, NY 10029

(212) 659-8551

Unlisted Fax

Mailing Location

17 E 102nd St, New York, NY 10029-5204

(212) 659-8551

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 390200000X Primary	Description Student in an Organized Health Care Education/Training Program Student, Health Care	License Unlisted Issuer

Douglas Rudolph Farrell

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Fahmy, Karim

Seemala, Sai Krishna Reddy

Gonzalez, Gisela

Ventura, Abby

Abou Lhosn, Petra

Shi, Ketai

Flores Sanga, Herson Santiago

Rehman, Zahoor Ur

Chaverri Alpizar, Kevin Guillermo

Ugochukwu, Nzubechukwu Judith