Provider Demographics
NPI:1043227481
Name:FERRARA, DANIEL C (OD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:C
Last Name:FERRARA
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 LYNNHAVEN PKWY STE 1189
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-7228
Mailing Address - Country:US
Mailing Address - Phone:757-463-2136
Mailing Address - Fax:757-463-8917
Practice Address - Street 1:701 LYNNHAVEN PKWY STE 1189
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-7228
Practice Address - Country:US
Practice Address - Phone:757-463-2136
Practice Address - Fax:757-463-8917
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618001233152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010022070Medicaid
VA00V958J01Medicare ID - Type Unspecified
VAU86581Medicare UPIN