Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 043012 | NY |
Y | 213EG0000X | General Practice | 043012 | NY |
NPI | 1003030081 |
---|---|
Provider Name | Dr. Jeannine M Ferriola |
First Address | Brooklyn, NY 11204-5622 |
Second Address | Brooklyn, NY 11204-5622 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2007 |
Last Update Date | 08/07/2007 |