Provider Demographics
NPI:1164509618
Name:FERRARA, JANENE MARIE
Entity Type:Individual
Prefix:
First Name:JANENE
Middle Name:MARIE
Last Name:FERRARA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2040 W END AVE
Mailing Address - Street 2:
Mailing Address - City:POTTSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17901-1922
Mailing Address - Country:US
Mailing Address - Phone:570-622-7291
Mailing Address - Fax:570-622-6011
Practice Address - Street 1:2040 W END AVE
Practice Address - Street 2:
Practice Address - City:POTTSVILLE
Practice Address - State:PA
Practice Address - Zip Code:17901-1922
Practice Address - Country:US
Practice Address - Phone:570-622-7291
Practice Address - Fax:570-622-6011
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT011760L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist