Provider Demographics
NPI:1629573886
Name:FERRIGNO-LAYTON, NICOLE ROSE (DO)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:ROSE
Last Name:FERRIGNO-LAYTON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 416457
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-6457
Mailing Address - Country:US
Mailing Address - Phone:844-362-1735
Mailing Address - Fax:973-290-7495
Practice Address - Street 1:11 OVERLOOK RD STE 230
Practice Address - Street 2:
Practice Address - City:SUMMIT
Practice Address - State:NJ
Practice Address - Zip Code:07901-3580
Practice Address - Country:US
Practice Address - Phone:908-522-5757
Practice Address - Fax:908-522-5779
Is Sole Proprietor?:No
Enumeration Date:2018-03-28
Last Update Date:2021-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB11044700208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics