Provider Demographics
NPI:1295843191
Name:FERRARO, MARIO L (MS PT)
Entity Type:Individual
Prefix:MR
First Name:MARIO
Middle Name:L
Last Name:FERRARO
Suffix:
Gender:M
Credentials:MS PT
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:55 GREENE AVE
Mailing Address - Street 2:STE 2A
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11238
Mailing Address - Country:US
Mailing Address - Phone:718-857-5939
Mailing Address - Fax:347-402-8421
Practice Address - Street 1:55 GREENE AVE
Practice Address - Street 2:STE 2A
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11238
Practice Address - Country:US
Practice Address - Phone:718-857-5939
Practice Address - Fax:347-402-8421
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2013-09-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY018358-1225100000X, 2251H1200X
FLPT17656225100000X, 2251H1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251H1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02547919Medicaid
NY1819961OtherUNITED HEALTH CARE
NY5090497OtherCIGNA
NY7108146OtherAETNA
NY7108146OtherAETNA