Provider Demographics
NPI:1629393046
Name:FERRANDINO, JOHN X (RPH)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:
Last Name:FERRANDINO
Suffix:X
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:142 BEACH 128TH ST
Mailing Address - Street 2:
Mailing Address - City:BELLE HARBOR
Mailing Address - State:NY
Mailing Address - Zip Code:11694-1605
Mailing Address - Country:US
Mailing Address - Phone:718-945-9311
Mailing Address - Fax:718-965-4204
Practice Address - Street 1:358 7TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-4315
Practice Address - Country:US
Practice Address - Phone:718-965-0565
Practice Address - Fax:718-965-4204
Is Sole Proprietor?:No
Enumeration Date:2010-03-29
Last Update Date:2010-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY034074183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist