1386612968 NPI number — GERALD W. FERRY M.D. P.C.

Table of content: (NPI 1386612968)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386612968 NPI number — GERALD W. FERRY M.D. P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GERALD W. FERRY M.D. P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
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:
1386612968
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/02/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2209 QUARRY DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
READING
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19609-1153
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-678-2400
Provider Business Mailing Address Fax Number:
610-678-2074

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2209 QUARRY DR
Provider Second Line Business Practice Location Address:
SUITE C30
Provider Business Practice Location Address City Name:
READING
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19609-1155
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-678-2400
Provider Business Practice Location Address Fax Number:
610-678-2074
Provider Enumeration Date:
03/09/2006

Additional Information

Authorized Official

Authorized Official Last Name:
FERRY
Authorized Official First Name:
GERALD
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
610-678-2400

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  MD016743E , 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: 000473069 . This is a "PA BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0019719000 . This is a "PERSONAL CHOICE ID NUMBER" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 02337300 . This is a "CAPITAL BLUE CROSS ID" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 232465097 . This is a "CORESOURCE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 232465097 . This is a "WAUSAU BENFITS INC." identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0019719000 . This is a "AMERIHEALTH PROVIDER ID." identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 151653 . This is a "KEYSTONE PROVIDER NUMBER" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 000473069 . This is a "KEYSTONE EAST" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 232465097 . This is a "FORTIS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 232465097 . This is a "BERKSHIRE HEALTH" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 232465097 . This is a "HEALTHASSURANCE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 232465097 . This is a "LOOMIS COMPANY" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 2324650970006 . This is a "CIGNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0019719000 . This is a "KEYSTONE EAST PROVIDER ID" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0151653 . This is a "KEYSTONE CENTRAL" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0019719000 . This is a "INDEPENDANCE BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 147643 . This is a "PA BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 232465097 . This is a "GREAT WEST INS. CO." identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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