Provider Demographics
NPI:1902037120
Name:FERRUCCI, MARCO (DC)
Entity Type:Individual
Prefix:DR
First Name:MARCO
Middle Name:
Last Name:FERRUCCI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:246 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:NUTLEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07110-1431
Mailing Address - Country:US
Mailing Address - Phone:973-477-8414
Mailing Address - Fax:
Practice Address - Street 1:110 BLOOMFIELD AVE
Practice Address - Street 2:SUITE B
Practice Address - City:CALDWELL
Practice Address - State:NJ
Practice Address - Zip Code:07006-5336
Practice Address - Country:US
Practice Address - Phone:973-229-0500
Practice Address - Fax:973-229-0501
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-05
Last Update Date:2009-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00676300111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor