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General NPI Number Information
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NPI Number | 1407103997
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Entity Type | Individual
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Provider Name | ISIS SACRAMENTO FERREIRA M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/14/2012
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Last Update Date | 08/14/2018
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Provider Practice Location Address
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Address Line | 8D CANAL CT
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City | AVON
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State | CT
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Zip | 06001
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Country | US
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Telephone | 860-674-9686
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Fax | 860-674-9954
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Provider Business Mailing Address
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Address Line | 8D CANAL CT
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City | AVON
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State | CT
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Zip | 06001-3747
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Country | US
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Telephone | 860-674-9686
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Fax | 860-674-9954
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 60384
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | D79058
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License Number State | MD
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