Healthcare Provider Details

I. General information

NPI: 1346226255
Provider Name (Legal Business Name): JAMES C FERENZI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 12/22/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 WALNUT ST
TOWANDA PA
18848-1939
US

IV. Provider business mailing address

12 WALNUT ST
TOWANDA PA
18848-1939
US

V. Phone/Fax

Practice location:
  • Phone: 570-265-7061
  • Fax:
Mailing address:
  • Phone: 570-265-7061
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD038559E
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: