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NPI Code Detail

MEDICARE: MRS. NICOLE MARIE FERLITO PA-C

MEDICARE: MRS. NICOLE MARIE FERLITO PA-C
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
1363A00000XPhysician Assistant5601006313MI

General Provider Information

NPI Number : 1861759755
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. NICOLE MARIE FERLITO PA-C
Provider Business Mailing Address
First Line : 130 TOWN CENTER DR STE 203
Second Line :
City : TROY
State : MI
Zip : 48084-1744
Country : US
Telephone Number : 248-585-8252
Fax Number :
Provider Business Practice Location Address
First Line : 3601 W 13 MILE RD
Second Line :
City : ROYAL OAK
State : MI
Zip : 48073-6712
Country : US
Telephone Number : 248-898-4021
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/16/2012
Last Update Date : 01/08/2026

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Directions to “ MRS. NICOLE MARIE FERLITO PA-C” Practice Location

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