Provider Demographics
NPI:1669712592
Name:FERRARO MORMINO, GINA (NNP)
Entity type:Individual
Prefix:MRS
First Name:GINA
Middle Name:
Last Name:FERRARO MORMINO
Suffix:
Gender:F
Credentials:NNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:30 PROSPECT AVE BLDG PC218
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-1915
Mailing Address - Country:US
Mailing Address - Phone:551-996-5362
Mailing Address - Fax:551-996-3232
Practice Address - Street 1:30 PROSPECT AVE BLDG PC218
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-1915
Practice Address - Country:US
Practice Address - Phone:551-996-5362
Practice Address - Fax:551-996-3232
Is Sole Proprietor?:No
Enumeration Date:2013-03-01
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF350350363LN0000X
NJ26NJ00621400363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal