Provider Demographics
NPI:1003259748
Name:FERZLI, GEORGINA MARIE (MD, MS)
Entity Type:Individual
Prefix:DR
First Name:GEORGINA
Middle Name:MARIE
Last Name:FERZLI
Suffix:
Gender:F
Credentials:MD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58A W 15TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-6835
Mailing Address - Country:US
Mailing Address - Phone:212-242-5815
Mailing Address - Fax:
Practice Address - Street 1:58A W 15TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-6835
Practice Address - Country:US
Practice Address - Phone:212-242-5815
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-11
Last Update Date:2018-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY283026390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program