Provider Demographics
NPI:1417017062
Name:FERRAO, JEANINE MCCAHILL (NP)
Entity Type:Individual
Prefix:MS
First Name:JEANINE
Middle Name:MCCAHILL
Last Name:FERRAO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 REGION DR
Mailing Address - Street 2:
Mailing Address - City:HAZLET
Mailing Address - State:NJ
Mailing Address - Zip Code:07730-2710
Mailing Address - Country:US
Mailing Address - Phone:732-738-1029
Mailing Address - Fax:
Practice Address - Street 1:400 OSBORNE TER
Practice Address - Street 2:SUITE L-4 CARDIAC TRANSPLANT
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07112-2046
Practice Address - Country:US
Practice Address - Phone:973-926-7205
Practice Address - Fax:973-923-8993
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN00011000363LA2200X
NYF302804363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0021491Medicaid
NJ078429TLFMedicare ID - Type Unspecified
NJ0021491Medicaid