Healthcare Provider Details

I. General information

NPI: 1871774331
Provider Name (Legal Business Name): CYNTHIA W FERRARI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/26/2007
Last Update Date: 11/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

147 N COMRIE AVE RITE AID
JOHNSTOWN NY
12095-1906
US

IV. Provider business mailing address

147 N COMRIE AVE RITE AID
JOHNSTOWN NY
12095-1906
US

V. Phone/Fax

Practice location:
  • Phone: 518-762-4311
  • Fax: 518-762-5235
Mailing address:
  • Phone: 518-762-4311
  • Fax: 518-762-5235

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number043740-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: