Provider Demographics
NPI:1891951539
Name:FERRARA, SAMUEL A (RPH)
Entity Type:Individual
Prefix:MR
First Name:SAMUEL
Middle Name:A
Last Name:FERRARA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 POPLAR LN
Mailing Address - Street 2:
Mailing Address - City:LE ROY
Mailing Address - State:NY
Mailing Address - Zip Code:14482-1214
Mailing Address - Country:US
Mailing Address - Phone:585-768-6340
Mailing Address - Fax:
Practice Address - Street 1:9 POPLAR LN
Practice Address - Street 2:
Practice Address - City:LE ROY
Practice Address - State:NY
Practice Address - Zip Code:14482-1214
Practice Address - Country:US
Practice Address - Phone:585-768-6340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-01
Last Update Date:2008-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018979183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist