Provider Demographics
NPI:1255578399
Name:FERRARIS, AMBRA (MD)
Entity type:Individual
Prefix:
First Name:AMBRA
Middle Name:
Last Name:FERRARIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 EMERY AVE
Mailing Address - Street 2:
Mailing Address - City:MENDHAM
Mailing Address - State:NJ
Mailing Address - Zip Code:07945-1604
Mailing Address - Country:US
Mailing Address - Phone:646-752-7195
Mailing Address - Fax:
Practice Address - Street 1:100 MADISON AVE
Practice Address - Street 2:MORRISTOWN MEDICAL CENTER
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-6136
Practice Address - Country:US
Practice Address - Phone:973-656-6280
Practice Address - Fax:973-290-7495
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-12
Last Update Date:2014-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA09295200207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine