Provider Demographics
NPI:1831289768
Name:FERRARA, ALEXANDER (OTR)
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:
Last Name:FERRARA
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1338 ROUTE 38
Mailing Address - Street 2:STE B
Mailing Address - City:HAINESPORT
Mailing Address - State:NJ
Mailing Address - Zip Code:08036-2754
Mailing Address - Country:US
Mailing Address - Phone:609-923-1253
Mailing Address - Fax:
Practice Address - Street 1:1338 ROUTE 38
Practice Address - Street 2:STE B
Practice Address - City:HAINESPORT
Practice Address - State:NJ
Practice Address - Zip Code:08036-2754
Practice Address - Country:US
Practice Address - Phone:609-923-1253
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2009-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJTR00003700225X00000X
PAOC003431L225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ043510ZDDCMedicare PIN
NJ149626Medicare PIN