Provider Demographics
NPI:1184961765
Name:FERRY, THOMAS (CCP)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:
Last Name:FERRY
Suffix:
Gender:M
Credentials:CCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3108 MONTGOMERY LN
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95355-7998
Mailing Address - Country:US
Mailing Address - Phone:484-368-9189
Mailing Address - Fax:
Practice Address - Street 1:1970 FAIRWAY OAKS DR
Practice Address - Street 2:
Practice Address - City:RIPON
Practice Address - State:CA
Practice Address - Zip Code:95366-9360
Practice Address - Country:US
Practice Address - Phone:484-368-9189
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-15
Last Update Date:2013-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes242T00000XTechnologists, Technicians & Other Technical Service ProvidersPerfusionist