Provider Demographics
NPI:1568107019
Name:FERRAZ NETO, JOSE CANDIDO DE SOUZA (MD)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:CANDIDO DE SOUZA
Last Name:FERRAZ NETO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1400 PELHAM PARKWAY SOUTH JACOBI MEDICAL CENTER
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461
Mailing Address - Country:US
Mailing Address - Phone:718-918-5642
Mailing Address - Fax:718-918-3174
Practice Address - Street 1:1400 PELHAM PARKWAY SOUTH JACOBI MEDICAL CENTER
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461
Practice Address - Country:US
Practice Address - Phone:718-918-5642
Practice Address - Fax:718-918-3174
Is Sole Proprietor?:No
Enumeration Date:2022-04-29
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program