1962598060 NPI number — DR. RYAN MARASIGAN FERRERAS O.D.

Table of content: DR. RYAN MARASIGAN FERRERAS O.D. (NPI 1962598060)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962598060 NPI number — DR. RYAN MARASIGAN FERRERAS O.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FERRERAS
Provider First Name:
RYAN
Provider Middle Name:
MARASIGAN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
O.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FERRERAS
Provider Other First Name:
FRANCISCO RYAN
Provider Other Middle Name:
MARASIGAN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
O.D.
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1962598060
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/02/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1593 17TH AVE E
Provider Second Line Business Mailing Address:
SUITE 107
Provider Business Mailing Address City Name:
SHAKOPEE
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55379-4427
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
651-229-4174
Provider Business Mailing Address Fax Number:
651-229-4108

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1593 17TH AVE E
Provider Second Line Business Practice Location Address:
SUITE 107
Provider Business Practice Location Address City Name:
SHAKOPEE
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55379-4427
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
651-229-4174
Provider Business Practice Location Address Fax Number:
651-229-4108
Provider Enumeration Date:
10/05/2006

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: 152W00000X , with the licence number:  2962 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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