1336327758 NPI number — MR. JOSEPH THOMAS FERRERO

Table of content: MR. JOSEPH THOMAS FERRERO (NPI 1336327758)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336327758 NPI number — MR. JOSEPH THOMAS FERRERO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FERRERO
Provider First Name:
JOSEPH
Provider Middle Name:
THOMAS
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1336327758
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/07/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1107 HEDGEROW LANE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PHILADELPHIA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19115
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-673-1863
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 GREENWOOD SQ 3333 STREET ROAD
Provider Second Line Business Practice Location Address:
STE 320 COMP SPORTS CARE SPECIALISTS INC
Provider Business Practice Location Address City Name:
BENSALEM
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19020
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-638-3597
Provider Business Practice Location Address Fax Number:
215-638-7430
Provider Enumeration Date:
02/07/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2251X0800X , with the licence number:  PA018479 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)