Provider Demographics
NPI:1104805647
Name:FERENZ, CLINT C (MD)
Entity type:Individual
Prefix:DR
First Name:CLINT
Middle Name:C
Last Name:FERENZ
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2315 RT 34 SO
Mailing Address - Street 2:STE D
Mailing Address - City:MANASQUAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08736
Mailing Address - Country:US
Mailing Address - Phone:732-974-0404
Mailing Address - Fax:732-449-4271
Practice Address - Street 1:2315 RT 34 SO
Practice Address - Street 2:STE D
Practice Address - City:MANASQUAN
Practice Address - State:NJ
Practice Address - Zip Code:08736
Practice Address - Country:US
Practice Address - Phone:732-974-0404
Practice Address - Fax:732-449-4271
Is Sole Proprietor?:No
Enumeration Date:2006-01-12
Last Update Date:2021-05-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA05295600207X00000X
NJMA52956207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ512118BC1Medicare PIN
NJB76196Medicare UPIN
1017220001Medicare NSC