Provider Demographics
NPI:1710305339
Name:FERRARA, SCOTT G (DO)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:G
Last Name:FERRARA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 ESSEX ST STE 103
Mailing Address - Street 2:
Mailing Address - City:LODI
Mailing Address - State:NJ
Mailing Address - Zip Code:07644-2709
Mailing Address - Country:US
Mailing Address - Phone:551-996-1370
Mailing Address - Fax:
Practice Address - Street 1:160 ESSEX ST STE 103
Practice Address - Street 2:
Practice Address - City:LODI
Practice Address - State:NJ
Practice Address - Zip Code:07644-2709
Practice Address - Country:US
Practice Address - Phone:551-996-1370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-01
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB10507200207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease