Healthcare Provider Details

I. General information

NPI: 1003040080
Provider Name (Legal Business Name): FRANK JAMES FERRARO SR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2009
Last Update Date: 05/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 RIVERVALE RD
RIVERVALE NJ
07675-6259
US

IV. Provider business mailing address

275 RIVERVALE RD
RIVERVALE NJ
07675-6259
US

V. Phone/Fax

Practice location:
  • Phone: 201-664-3613
  • Fax: 201-664-6004
Mailing address:
  • Phone: 201-664-3613
  • Fax: 201-664-6004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number25MAO1613700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: