Provider Demographics
NPI:1962501221
Name:FERRIS, RICK (DO)
Entity Type:Individual
Prefix:
First Name:RICK
Middle Name:
Last Name:FERRIS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3402 WILLIAM FLYNN HWY
Mailing Address - Street 2:
Mailing Address - City:ALLISON PARK
Mailing Address - State:PA
Mailing Address - Zip Code:15101-3801
Mailing Address - Country:US
Mailing Address - Phone:412-486-3181
Mailing Address - Fax:412-487-3565
Practice Address - Street 1:3402 WILLIAM FLYNN HWY
Practice Address - Street 2:
Practice Address - City:ALLISON PARK
Practice Address - State:PA
Practice Address - Zip Code:15101-3801
Practice Address - Country:US
Practice Address - Phone:412-486-3181
Practice Address - Fax:412-487-3565
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS006340L207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0012475400001Medicaid
PA673633KL5Medicare ID - Type Unspecified
PAE86754Medicare UPIN