Provider Demographics
NPI:1992808315
Name:FERRANDO, DENISE MARCELLE (MD)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:MARCELLE
Last Name:FERRANDO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2233 STATE ROUTE 86
Mailing Address - Street 2:
Mailing Address - City:SARANAC LAKE
Mailing Address - State:NY
Mailing Address - Zip Code:12983-5644
Mailing Address - Country:US
Mailing Address - Phone:518-891-1733
Mailing Address - Fax:518-891-6764
Practice Address - Street 1:309 COUNTY RT 47
Practice Address - Street 2:SUITE #2
Practice Address - City:SARANAC LAKE
Practice Address - State:NY
Practice Address - Zip Code:12983
Practice Address - Country:US
Practice Address - Phone:518-891-1733
Practice Address - Fax:518-891-6764
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-07
Last Update Date:2018-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1609501207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00893169Medicaid
NY40048BMedicare ID - Type Unspecified
NY00893169Medicaid