Provider Demographics
NPI:1326362211
Name:GERALD S. FERENSTEIN, M.D., P.C.
Entity Type:Organization
Organization Name:GERALD S. FERENSTEIN, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:S
Authorized Official - Last Name:FERENSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:402-592-4750
Mailing Address - Street 1:401 E GOLD COAST RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:PAPILLION
Mailing Address - State:NE
Mailing Address - Zip Code:68046-4194
Mailing Address - Country:US
Mailing Address - Phone:402-592-4750
Mailing Address - Fax:402-592-4750
Practice Address - Street 1:401 E GOLD COAST RD
Practice Address - Street 2:SUITE 203
Practice Address - City:PAPILLION
Practice Address - State:NE
Practice Address - Zip Code:68046-4194
Practice Address - Country:US
Practice Address - Phone:402-592-4750
Practice Address - Fax:402-592-4750
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GERALD S. FERENSTEIN, M.D., P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-03-21
Last Update Date:2010-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NEOB12739261QS0132X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS0132XAmbulatory Health Care FacilitiesClinic/CenterOphthalmologic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE1902923097OtherNPI INDIVIUDAL
NE=========00Medicaid
NE=========00Medicaid