Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 0127 | NH |
Y | 222Z00000X | Podiatrist | 0127 | NH |
N | 213E00000X | Podiatrist | 90 | VT |
N | 222Z00000X | Podiatrist | 90 | VT |
NPI | 1023025251 |
---|---|
Provider Name | Dr. William B Ferriter JR. |
First Address | Thetford, VT 05074-0127 |
Second Address | Rutland, VT 05701 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2006 |
Last Update Date | 23/09/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00000063 | (05) | NH |
0008242 | (05) | VT |
0127 | LICENSE # (01) | NH |
90 | STATE LICENSE # (01) | VT |
CA11038331 | RAILROAD MEDICARE (01) | |
U0338 | (02) |