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NPI Code Detail

MEDICARE: RYAN VAN DE WATER FERULLO

MEDICARE: RYAN VAN DE WATER FERULLO
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1992657563
Entity Type Code : Individual
Provider Name (Legal Business Name) : RYAN VAN DE WATER FERULLO
Provider Business Mailing Address
First Line : 350 FAIRWAY DR
Second Line :
City : DEERFIELD BEACH
State : FL
Zip : 33441-1834
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 262 SWANSEA MALL DR STE 701
Second Line :
City : SWANSEA
State : MA
Zip : 02777-4151
Country : US
Telephone Number : 877-418-2978
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/13/2026
Last Update Date : 02/13/2026

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Directions to “ RYAN VAN DE WATER FERULLO ” Practice Location

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