Provider Demographics
NPI:1114907268
Name:FERRARO, PETER (D C)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:
Last Name:FERRARO
Suffix:
Gender:M
Credentials:D C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 SOUTH MIDLAND AVE
Mailing Address - Street 2:
Mailing Address - City:SADDLE BROOK
Mailing Address - State:NJ
Mailing Address - Zip Code:07663-6411
Mailing Address - Country:US
Mailing Address - Phone:973-478-2212
Mailing Address - Fax:973-478-2123
Practice Address - Street 1:230 SOUTH MIDLAND AVE
Practice Address - Street 2:
Practice Address - City:SADDLE BROOK
Practice Address - State:NJ
Practice Address - Zip Code:07663-6411
Practice Address - Country:US
Practice Address - Phone:973-478-2212
Practice Address - Fax:973-478-2123
Is Sole Proprietor?:No
Enumeration Date:2006-01-17
Last Update Date:2017-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC05056111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJU63961Medicare UPIN
NJ951904Medicare ID - Type Unspecified