Provider Demographics
NPI:1215672936
Name:FERRARA, NICOLE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:
Last Name:FERRARA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 WEGMANS MARKET ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14624-3304
Mailing Address - Country:US
Mailing Address - Phone:800-934-4797
Mailing Address - Fax:
Practice Address - Street 1:175 HUMBOLDT ST STE 225
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14610-1000
Practice Address - Country:US
Practice Address - Phone:585-482-4978
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-28
Last Update Date:2022-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY067813-I183500000X
VA0202213437183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist