Provider Demographics
NPI:1760414882
Name:FERRARO, DONNA JANE (MD)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:JANE
Last Name:FERRARO
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 1:275 RIVER VALE ROAD
Mailing Address - Street 2:
Mailing Address - City:RIVER VALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07675
Mailing Address - Country:US
Mailing Address - Phone:201-664-6566
Mailing Address - Fax:201-664-6004
Practice Address - Street 1:275 RIVER VALE ROAD
Practice Address - Street 2:
Practice Address - City:RIVER VALE
Practice Address - State:NJ
Practice Address - Zip Code:07675
Practice Address - Country:US
Practice Address - Phone:201-664-6566
Practice Address - Fax:201-664-6004
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA058252208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6558909Medicaid
NJ502639ZUAQMedicare PIN
NJ6558909Medicaid
FE502639Medicare ID - Type Unspecified