Provider Demographics
NPI:1710055439
Name:LATERRA-FERRARO, NANCY T (MS, RN, CP NP)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:T
Last Name:LATERRA-FERRARO
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Gender:F
Credentials:MS, RN, CP NP
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Mailing Address - Street 1:40 MATTHEWS ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:GOSHEN
Mailing Address - State:NY
Mailing Address - Zip Code:10924-1986
Mailing Address - Country:US
Mailing Address - Phone:845-360-5373
Mailing Address - Fax:845-360-5669
Practice Address - Street 1:40 MATTHEWS ST
Practice Address - Street 2:SUITE 201
Practice Address - City:GOSHEN
Practice Address - State:NY
Practice Address - Zip Code:10924-1986
Practice Address - Country:US
Practice Address - Phone:845-360-5373
Practice Address - Fax:845-360-5669
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2023-03-07
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Provider Licenses
StateLicense IDTaxonomies
NY381310-1363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY381310-1OtherLICENSE
NYML0561298OtherDEA