=====================================================
General NPI Number Information
=====================================================
NPI Number | 1669556650
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | PEDRO FERRANDO-ROSS MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/25/2006
-----------------------------------------------------
Last Update Date | 04/15/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 211 CHURCH STREET SARATOGA HOSPITAL
-----------------------------------------------------
City | SARATOGA SPRINGS
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 12866
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 518-886-5960
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1 BRITTANY TER
-----------------------------------------------------
City | GANSEVOORT
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 12831-3224
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 518-928-4690
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207P00000X
-----------------------------------------------------
Taxonomy Name | Emergency Medicine Physician
-----------------------------------------------------
License Number | 193108
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------