MEDICARE: ANDREW FERRARO MD, DDS

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	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	305710	NY
2	204E00000X	Oral & Maxillofacial Surgery (D.M.D.)	305710	NY
3	390200000X	Student in an Organized Health Care Education/Training Program	934444003	NY
4	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	11418	TN

General Provider Information

NPI Number	:	1780094052
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREW FERRARO MD, DDS

Provider Business Mailing Address
First Line	:	7 WESTERN LN
Second Line	:
City	:	WANTAGH
State	:	NY
Zip	:	11793-1208
Country	:	US
Telephone Number	:	917-860-2391
Fax Number	:

Provider Business Practice Location Address
First Line	:	2964 MILLER PLACE WAY
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37924-1673
Country	:	US
Telephone Number	:	917-860-2391
Fax Number	:

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

Provider Enumeration Date	:	05/07/2014
Last Update Date	:	08/31/2020

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