Provider Demographics
NPI:1477809739
Name:FERRO, BRYAN A
Entity Type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:A
Last Name:FERRO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 THORNTON RD
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15417-4600
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1009 MAIN STREET
Practice Address - Street 2:BOX 757
Practice Address - City:REPUBLIC
Practice Address - State:PA
Practice Address - Zip Code:15475
Practice Address - Country:US
Practice Address - Phone:724-246-8800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-24
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP441335183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist