Provider Demographics
NPI:1043683097
Name:FERRY CHIROPRACTIC
Entity Type:Organization
Organization Name:FERRY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:A
Authorized Official - Last Name:FERRY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:716-681-6000
Mailing Address - Street 1:5333 TRANSIT RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:DEPEW
Mailing Address - State:NY
Mailing Address - Zip Code:14043-4333
Mailing Address - Country:US
Mailing Address - Phone:716-681-6000
Mailing Address - Fax:716-681-3111
Practice Address - Street 1:5333 TRANSIT RD
Practice Address - Street 2:SUITE C
Practice Address - City:DEPEW
Practice Address - State:NY
Practice Address - Zip Code:14043-4333
Practice Address - Country:US
Practice Address - Phone:716-681-6000
Practice Address - Fax:716-681-3111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-12
Last Update Date:2015-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011891111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYJ400068737Medicare UPIN