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General NPI Number Information
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NPI Number | 1508553108
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Entity Type | Organization
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Legal Business Name | DR. B. J. FERRACCIO, LLC
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Dates
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Enumeration Date | 04/24/2023
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Last Update Date | 06/30/2023
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Provider Practice Location Address
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Address Line | 204 5TH AVENUE STE 402
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City | PITTSBURGH
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State | PA
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Zip | 15222-2706
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Country | US
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Telephone | 724-244-5763
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Fax |
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Provider Business Mailing Address
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Address Line | 330 EVERGREEN CT
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City | APOLLO
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State | PA
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Zip | 15613-1269
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Country | US
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Telephone | 724-244-5763
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER / PSYCHOLOGIST
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Name | DR. BRIAN JOSEPH FERRACCIO
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Credential | PSY.D.
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Telephone | 724-244-5763
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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