1811275910 NPI number — MS. JEANINE CARROLL FERRONE PT,MS

Table of content: MS. JEANINE CARROLL FERRONE PT,MS (NPI 1811275910)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811275910 NPI number — MS. JEANINE CARROLL FERRONE PT,MS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FERRONE
Provider First Name:
JEANINE
Provider Middle Name:
CARROLL
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
PT,MS
Provider Gender Code:
F

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:
1811275910
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/25/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
800 E GATE BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GARDEN CITY
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11530-2105
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
516-745-8050
Provider Business Mailing Address Fax Number:
516-745-6766

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 LANDING RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROSLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11576-1102
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
516-745-8050
Provider Business Practice Location Address Fax Number:
516-745-6766
Provider Enumeration Date:
07/25/2011

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: 225100000X , with the licence number:  009361-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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