Provider Demographics
NPI:1427166198
Name:FERRARA, GERALDINE (APN)
Entity type:Individual
Prefix:MRS
First Name:GERALDINE
Middle Name:
Last Name:FERRARA
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1617 ROUTE 88 W
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08724-3010
Mailing Address - Country:US
Mailing Address - Phone:732-458-5067
Mailing Address - Fax:732-458-4962
Practice Address - Street 1:1617 ROUTE 88 W
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08724-3010
Practice Address - Country:US
Practice Address - Phone:732-458-5067
Practice Address - Fax:732-458-4962
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26N006795300363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
P22561Medicare UPIN
044777BSBMedicare PIN