Provider Demographics
NPI:1104296573
Name:FERREIRA, JARED
Entity type:Individual
Prefix:
First Name:JARED
Middle Name:
Last Name:FERREIRA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 BULLOCK RD
Mailing Address - Street 2:
Mailing Address - City:EAST FREETOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02717-1419
Mailing Address - Country:US
Mailing Address - Phone:508-685-9703
Mailing Address - Fax:
Practice Address - Street 1:185 BULLOCK RD
Practice Address - Street 2:
Practice Address - City:EAST FREETOWN
Practice Address - State:MA
Practice Address - Zip Code:02717-1419
Practice Address - Country:US
Practice Address - Phone:508-685-9703
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-29
Last Update Date:2015-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer