Provider Demographics
NPI:1508829391
Name:FERRERO, JOSE V (MD)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:V
Last Name:FERRERO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:607 PRITCHARDS HILL CT
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-2653
Mailing Address - Country:US
Mailing Address - Phone:787-370-9292
Mailing Address - Fax:
Practice Address - Street 1:10340 SPOTSYLVANIA AVE STE 101
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22408
Practice Address - Country:US
Practice Address - Phone:540-374-3164
Practice Address - Fax:540-899-1342
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-11
Last Update Date:2018-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11455208100000X
VA0101262365208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR88425Medicare ID - Type Unspecified
PRG41190Medicare UPIN