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NPI Code Detail

MEDICARE: DR. THOMAS M FERENCE PHD, MPH

MEDICARE: DR. THOMAS M FERENCE PHD, MPH
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
1103TC0700XClinical Psychologist5764OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1740387745
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. THOMAS M FERENCE PHD, MPH
Provider Business Mailing Address
First Line : 25000 EUCLID AVE STE 406
Second Line :
City : EUCLID
State : OH
Zip : 44117-2645
Country : US
Telephone Number : 216-731-8815
Fax Number : 216-731-8816
Provider Business Practice Location Address
First Line : 1756 SAGAMORE RD
Second Line :
City : NORTHFIELD
State : OH
Zip : 44067-1086
Country : US
Telephone Number : 330-467-7131
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2006
Last Update Date : 01/03/2022

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