Provider Demographics
NPI:1770620833
Name:FERRAR, IAN CRAIG (DC)
Entity type:Individual
Prefix:
First Name:IAN
Middle Name:CRAIG
Last Name:FERRAR
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:174 GRAND ST
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10601-4803
Mailing Address - Country:US
Mailing Address - Phone:914-328-8077
Mailing Address - Fax:914-328-6083
Practice Address - Street 1:176 GRAND ST
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601-4803
Practice Address - Country:US
Practice Address - Phone:914-328-6080
Practice Address - Fax:914-328-6081
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX007009111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA400069316Medicare PIN
NYX494038171Medicare PIN
NYX49401Medicare UPIN
NYX494039041Medicare PIN
NYA400049754Medicare PIN