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General NPI Number Information
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NPI Number | 1205883139
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Entity Type | Individual
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Provider Name | BRADLEY J. FERRARA MD
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Gender | Male
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Dates
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Enumeration Date | 05/27/2006
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Last Update Date | 11/17/2010
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Provider Practice Location Address
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Address Line | 2325 MARYLAND ROAD SUITE 200
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City | WILLOW GROVE
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State | PA
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Zip | 19090
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Country | US
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Telephone | 215-657-9393
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Fax | 215-657-9398
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Provider Business Mailing Address
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Address Line | 2325 MARYLAND RD STE 200
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City | WILLOW GROVE
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State | PA
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Zip | 19090-1760
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Country | US
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Telephone | 215-657-9393
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Fax | 215-657-9398
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | MD067744L
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License Number State | PA
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