Healthcare Provider Details

I. General information

NPI: 1508553108
Provider Name (Legal Business Name): DR. B. J. FERRACCIO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2023
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4748 LIBERTY AVE
PITTSBURGH PA
15224-2034
US

IV. Provider business mailing address

330 EVERGREEN CT
APOLLO PA
15613-1269
US

V. Phone/Fax

Practice location:
  • Phone: 724-244-5763
  • Fax:
Mailing address:
  • Phone: 724-244-5763
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. BRIAN JOSEPH FERRACCIO
Title or Position: MANAGING MEMBER / PSYCHOLOGIST
Credential: PSY.D.
Phone: 724-244-5763