Provider Demographics
NPI:1912194515
Name:FARNSWORTH, JUDY HARRIS (PA)
Entity type:Individual
Prefix:MS
First Name:JUDY
Middle Name:HARRIS
Last Name:FARNSWORTH
Suffix:
Gender:F
Credentials:PA
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Other - Credentials:
Mailing Address - Street 1:1455 EAST PUTNAM AVENUE
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:OLD GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06870
Mailing Address - Country:US
Mailing Address - Phone:203-637-3337
Mailing Address - Fax:203-637-3307
Practice Address - Street 1:1455 EAST PUTNAM AVENUE
Practice Address - Street 2:1ST FLOOR
Practice Address - City:OLD GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06870
Practice Address - Country:US
Practice Address - Phone:203-637-3337
Practice Address - Fax:203-637-3307
Is Sole Proprietor?:No
Enumeration Date:2007-09-27
Last Update Date:2024-08-02
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTB83222Medicare UPIN