Provider Demographics
NPI:1922093251
Name:FERRETTI, MARCOLINO (MD)
Entity Type:Individual
Prefix:DR
First Name:MARCOLINO
Middle Name:
Last Name:FERRETTI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:234 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:RI
Mailing Address - Zip Code:02806-3406
Mailing Address - Country:US
Mailing Address - Phone:401-247-1644
Mailing Address - Fax:401-247-4961
Practice Address - Street 1:234 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:BARRINGTON
Practice Address - State:RI
Practice Address - Zip Code:02806-3406
Practice Address - Country:US
Practice Address - Phone:401-247-1644
Practice Address - Fax:401-247-4961
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-13
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI9813208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
206325OtherBLUE CROSS
1201213OtherUNITED HEALTH CARE
404256OtherTUFTS
402824OtherBLUE CHIP
RI9813OtherMEDICAL LIC
710048501OtherCIGNA
RI9020632Medicaid
BF59292OtherDEA