Healthcare Provider Details

I. General information

NPI: 1710055439
Provider Name (Legal Business Name): NANCY T LATERRA-FERRARO MS, RN, CP NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/01/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 MATTHEWS ST SUITE 201
GOSHEN NY
10924-1986
US

IV. Provider business mailing address

40 MATTHEWS ST SUITE 201
GOSHEN NY
10924-1986
US

V. Phone/Fax

Practice location:
  • Phone: 845-360-5373
  • Fax: 845-360-5669
Mailing address:
  • Phone: 845-360-5373
  • Fax: 845-360-5669

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number381310-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: