Provider Demographics
NPI:1720532708
Name:FERRANTI, DEREK
Entity type:Individual
Prefix:
First Name:DEREK
Middle Name:
Last Name:FERRANTI
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 1:620 W 42ND ST APT 5C
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10036-2018
Mailing Address - Country:US
Mailing Address - Phone:401-595-3957
Mailing Address - Fax:
Practice Address - Street 1:565 MANHATTAN AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10027-5250
Practice Address - Country:US
Practice Address - Phone:212-316-7942
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-08
Last Update Date:2025-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY601016372500000X
NY356834363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No372500000XNursing Service Related ProvidersChore Provider