Healthcare Provider Details

I. General information

NPI: 1811022544
Provider Name (Legal Business Name): JOHN W FERRANTE MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2007
Last Update Date: 11/14/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1314 PARK AVE
PLAINFIELD NJ
07060-3253
US

IV. Provider business mailing address

1314 PARK AVE
PLAINFIELD NJ
07060-3253
US

V. Phone/Fax

Practice location:
  • Phone: 908-756-6218
  • Fax: 908-756-7944
Mailing address:
  • Phone: 908-756-6218
  • Fax: 908-756-7944

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number25MA02053600
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License Number25MA02053600
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number25MA02053600
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier1067001
Identifier TypeMEDICAID
Identifier StateNJ
Identifier Issuer

VIII. Authorized Official

Name: ANN MARIE FERRANTE
Title or Position: PRACTICE ADMINISTRATOR
Credential: CMM
Phone: 908-756-6218