=====================================================
General NPI Number Information
=====================================================
NPI Number | 1205020898
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JOHN J FERRI PT, DPT, MS, ATC
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/28/2007
-----------------------------------------------------
Last Update Date | 08/28/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 201 PLEASANT HILL RD
-----------------------------------------------------
City | CHESTER
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07930-2141
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 973-252-6373
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 39 N MAIN ST
-----------------------------------------------------
City | HACKETTSTOWN
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07840
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 908-979-1123
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | 40QA01250000
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------