Healthcare Provider Details

I. General information

NPI: 1518982032
Provider Name (Legal Business Name): JOSEPH VINCENT FERRARO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 09/28/2020
Certification Date: 09/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2729 KING ST
ALEXANDRIA VA
22302-4008
US

IV. Provider business mailing address

5537 DEALE CHURCHTON RD # 533
CHURCHTON MD
20733-9998
US

V. Phone/Fax

Practice location:
  • Phone: 703-836-8838
  • Fax:
Mailing address:
  • Phone: 352-327-2140
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberD0068463
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberD68463
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: