Healthcare Provider Details

I. General information

NPI: 1164474987
Provider Name (Legal Business Name): JOHN A. FERRO, M.D., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 RONALD REAGAN BLVD
WARWICK NY
10990-4105
US

IV. Provider business mailing address

85 RONALD REAGAN BLVD
WARWICK NY
10990-4105
US

V. Phone/Fax

Practice location:
  • Phone: 845-986-8722
  • Fax: 845-986-8838
Mailing address:
  • Phone: 845-986-8722
  • Fax: 845-986-8838

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number179984
License Number StateNY

VIII. Authorized Official

Name: DR. JOHN ALFRED FERRO
Title or Position: PRESIDENT
Credential: M.D.
Phone: 845-325-3009