MEDICARE: KIMBERLY FEREZA

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	225100000X	Physical Therapist	PT008670L	PA

Other Identifiers

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

General Provider Information

NPI Number	:	1871781526
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY FEREZA

Provider Business Mailing Address
First Line	:	950 S CENTRAL AVE STE 6
Second Line	:
City	:	CANONSBURG
State	:	PA
Zip	:	15317-1489
Country	:	US
Telephone Number	:	724-884-6936
Fax Number	:

Provider Business Practice Location Address
First Line	:	950 S CENTRAL AVE STE 6
Second Line	:
City	:	CANONSBURG
State	:	PA
Zip	:	15317-1489
Country	:	US
Telephone Number	:	724-844-6936
Fax Number	:

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

Provider Enumeration Date	:	10/09/2007
Last Update Date	:	11/16/2020

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Directions to “ KIMBERLY FEREZA ” Practice Location

Language	Start Address	Practice Location

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