Provider Demographics
NPI:1477893741
Name:FERRARI, MELISSA JEAN (PA-C)
Entity Type:Individual
Prefix:MISS
First Name:MELISSA
Middle Name:JEAN
Last Name:FERRARI
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:3400 SPRUCE ST
Mailing Address - Street 2:PCAM 4 S
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-4238
Mailing Address - Country:US
Mailing Address - Phone:215-349-8222
Mailing Address - Fax:
Practice Address - Street 1:3400 SPRUCE ST
Practice Address - Street 2:2 DULLES LIVER TRANSPLANT
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4238
Practice Address - Country:US
Practice Address - Phone:215-349-8222
Practice Address - Fax:215-615-1601
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-25
Last Update Date:2015-01-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY016339-1363A00000X
PAMA055970363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant