Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 25MAO1613700 | NJ |
NPI | 1003040080 |
---|---|
Provider Name | Dr. Frank James Ferraro SR. |
First Address | Rivervale, NJ 07675-6259 |
Second Address | Rivervale, NJ 07675-6259 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/05/2009 |
Last Update Date | 06/05/2009 |