Provider Demographics
NPI:1477766954
Name:FERRARA, ANGELO NICHOLAS (DC)
Entity Type:Individual
Prefix:DR
First Name:ANGELO
Middle Name:NICHOLAS
Last Name:FERRARA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 ODELL AVE
Mailing Address - Street 2:
Mailing Address - City:ENDICOTT
Mailing Address - State:NY
Mailing Address - Zip Code:13760-2820
Mailing Address - Country:US
Mailing Address - Phone:607-748-4448
Mailing Address - Fax:607-748-3975
Practice Address - Street 1:333 ODELL AVE
Practice Address - Street 2:
Practice Address - City:ENDICOTT
Practice Address - State:NY
Practice Address - Zip Code:13760-2820
Practice Address - Country:US
Practice Address - Phone:607-748-4448
Practice Address - Fax:607-748-3975
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX-000101-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY806367OtherEMPIRE NUMBER
NY000101-8WOtherWC NUMBER
NY000101-8WOtherWC NUMBER