Healthcare Provider Details

I. General information

NPI: 1588903702
Provider Name (Legal Business Name): GENEVIEVE FERRER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2013
Last Update Date: 02/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

403 BICYCLE PATH
PORT JEFF STA NY
11776-3403
US

IV. Provider business mailing address

403 BICYCLE PATH
PORT JEFF STA NY
11776-3403
US

V. Phone/Fax

Practice location:
  • Phone: 631-334-7713
  • Fax:
Mailing address:
  • Phone: 631-334-7713
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number660811
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: