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General NPI Number Information
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NPI Number | 1255480638
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Entity Type | Organization
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Legal Business Name | MARK J FERRI DO PROFESSIONAL LLC
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Dates
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Enumeration Date | 01/09/2007
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Last Update Date | 02/10/2023
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Provider Practice Location Address
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Address Line | 122 ONEAWA ST 101
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City | KAILUA
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State | HI
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Zip | 96734-2524
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Country | US
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Telephone | 808-263-4263
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Fax | 808-263-4263
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Provider Business Mailing Address
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Address Line | 122 ONEAWA ST 101
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City | KAILUA
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State | HI
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Zip | 96734-2524
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Country | US
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Telephone | 808-263-4263
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Fax | 808-263-4263
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARK J FERRI
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Credential | DO
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Telephone | 808-263-4263
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 965
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License Number State | HI
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