Provider Demographics
NPI:1649014317
Name:FERULLO, EMILY CATHERINE (PHYSICIAN ASSISTANT)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:CATHERINE
Last Name:FERULLO
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 EXETER ST APT 606
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02116-4844
Mailing Address - Country:US
Mailing Address - Phone:339-227-7662
Mailing Address - Fax:
Practice Address - Street 1:1275 WAMPANOAG TRL
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:RI
Practice Address - Zip Code:02915-1217
Practice Address - Country:US
Practice Address - Phone:401-415-8586
Practice Address - Fax:401-414-7335
Is Sole Proprietor?:No
Enumeration Date:2024-06-19
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant