Provider Demographics
NPI:1659302941
Name:FERRANTE, JEANNE M (MD)
Entity Type:Individual
Prefix:
First Name:JEANNE
Middle Name:M
Last Name:FERRANTE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 GEORGE ST STE 100
Mailing Address - Street 2:
Mailing Address - City:NEW BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08901-2047
Mailing Address - Country:US
Mailing Address - Phone:732-235-8993
Mailing Address - Fax:732-246-7317
Practice Address - Street 1:317 GEORGE ST STE 100
Practice Address - Street 2:
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-2047
Practice Address - Country:US
Practice Address - Phone:732-235-8993
Practice Address - Fax:732-246-7317
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2021-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07168100207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJP00993886OtherRR MCR PTAN
NJ8486301Medicaid
E16647Medicare UPIN
NJ046090Medicare ID - Type Unspecified
NJ046090DFFMedicare PIN
NJ046090A02Medicare PIN