Provider Demographics
NPI:1407800618
Name:FERRER, IRENE M (PT)
Entity Type:Individual
Prefix:
First Name:IRENE
Middle Name:M
Last Name:FERRER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:IRENE
Other - Middle Name:T
Other - Last Name:MOLINA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1225 RICHMOND RD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10304-2415
Mailing Address - Country:US
Mailing Address - Phone:718-477-2971
Mailing Address - Fax:718-659-0704
Practice Address - Street 1:1225 RICHMOND RD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10304-2415
Practice Address - Country:US
Practice Address - Phone:718-477-2971
Practice Address - Fax:718-659-0704
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017971-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQA8591Medicare ID - Type UnspecifiedPROVIDER NUMBER