MEDICARE: MRS. GERALDINE FERRARA APN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner	26N006795300	NJ

General Provider Information

NPI Number	:	1427166198
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. GERALDINE FERRARA APN

Provider Business Mailing Address
First Line	:	1617 ROUTE 88 W
Second Line	:
City	:	BRICK
State	:	NJ
Zip	:	08724-3010
Country	:	US
Telephone Number	:	732-458-5067
Fax Number	:	732-458-4962

Provider Business Practice Location Address
First Line	:	1617 ROUTE 88 W
Second Line	:
City	:	BRICK
State	:	NJ
Zip	:	08724-3010
Country	:	US
Telephone Number	:	732-458-5067
Fax Number	:	732-458-4962

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/25/2006
Last Update Date	:	11/27/2007

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