Provider Demographics
NPI:1528022498
Name:FERDINANDO, EDWARD JOSEPH (DPM)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:JOSEPH
Last Name:FERDINANDO
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:970 BARD AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10301-3322
Mailing Address - Country:US
Mailing Address - Phone:718-720-6866
Mailing Address - Fax:718-720-6931
Practice Address - Street 1:970 BARD AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10301-3322
Practice Address - Country:US
Practice Address - Phone:718-720-6866
Practice Address - Fax:718-720-6931
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-17
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN003558-1213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00836526Medicaid
NYP38551Medicare PIN
NY0828610001Medicare NSC
NYT51166Medicare UPIN