Provider Demographics
NPI:1942220694
Name:FERRERI, C. JOHN (RPH)
Entity Type:Individual
Prefix:MR
First Name:C.
Middle Name:JOHN
Last Name:FERRERI
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:PO BOX 33
Mailing Address - Street 2:
Mailing Address - City:STORRS MANSFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06268-0033
Mailing Address - Country:US
Mailing Address - Phone:860-429-6970
Mailing Address - Fax:
Practice Address - Street 1:1232 STORRS RD
Practice Address - Street 2:
Practice Address - City:STORRS MANSFIELD
Practice Address - State:CT
Practice Address - Zip Code:06268-2232
Practice Address - Country:US
Practice Address - Phone:860-429-9365
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT4018183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist