1821096876 NPI number — FRANCIS T FERRARO MD

Table of content: FRANCIS T FERRARO MD (NPI 1821096876)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821096876 NPI number — FRANCIS T FERRARO MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FERRARO
Provider First Name:
FRANCIS
Provider Middle Name:
T
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1821096876
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/10/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1086 FRANKLIN ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
JOHNSTOWN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15905-4305
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
814-410-8300
Provider Business Mailing Address Fax Number:
814-410-8331

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1111 FRANKLIN ST
Provider Second Line Business Practice Location Address:
STE 130
Provider Business Practice Location Address City Name:
JOHNSTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15905-4330
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-534-5724
Provider Business Practice Location Address Fax Number:
814-536-1786
Provider Enumeration Date:
07/13/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207T00000X , with the licence number:  MD037878E , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0010892710003 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0010892710005 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0667685 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3810010809 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".




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