Provider Demographics
NPI:1841322732
Name:FERRAGAMO, VINCENT A (DDS)
Entity type:Individual
Prefix:
First Name:VINCENT
Middle Name:A
Last Name:FERRAGAMO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:327 NASSAU BLVD
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-5313
Mailing Address - Country:US
Mailing Address - Phone:516-489-6664
Mailing Address - Fax:516-486-4909
Practice Address - Street 1:327 NASSAU BLVD
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-5313
Practice Address - Country:US
Practice Address - Phone:516-489-6664
Practice Address - Fax:516-486-4909
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0244391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice