Provider Demographics
NPI:1831575067
Name:FERRO, NICOLE NATASHA (DO)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:NATASHA
Last Name:FERRO
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 SCHULZ DR STE 2
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-6745
Mailing Address - Country:US
Mailing Address - Phone:732-426-3420
Mailing Address - Fax:
Practice Address - Street 1:331 NEWMAN SPRINGS RD STE 200
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-5691
Practice Address - Country:US
Practice Address - Phone:732-242-7101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-11
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ0000000000000000208100000X
FLOS16449208100000X, 208VP0014X
NJ25MB10739700208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine