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General NPI Number Information
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NPI Number | 1538623624
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Entity Type | Individual
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Provider Name | PETER SALVATORE FERRETTI
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Gender | Male
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Dates
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Enumeration Date | 01/23/2019
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Last Update Date | 01/23/2019
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Provider Practice Location Address
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Address Line | 5151 PARK AVE
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City | FAIRFIELD
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State | CT
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Zip | 06825-1090
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Country | US
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Telephone | 914-703-7583
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Fax |
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Provider Business Mailing Address
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Address Line | 17 SOMERSET DR
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City | SOMERS
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State | NY
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Zip | 10589-2914
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Country | US
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Telephone | 914-277-8134
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Fax |
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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