Provider Demographics
NPI:1710434188
Name:FERRIS, SEAN ERNEST
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:ERNEST
Last Name:FERRIS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 FLYNN AVE
Mailing Address - Street 2:
Mailing Address - City:MARLBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01752-1920
Mailing Address - Country:US
Mailing Address - Phone:774-249-5902
Mailing Address - Fax:
Practice Address - Street 1:33 TURNPIKE RD
Practice Address - Street 2:
Practice Address - City:SOUTHBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01772-2108
Practice Address - Country:US
Practice Address - Phone:508-481-1015
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-02
Last Update Date:2016-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst