Individual
NICOLE FERRANTELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
100 MERRICK RD, SUITE 128W, ROCKVILLE CENTRE, NY 11570-4800
(516) 255-9031
Mailing address
100 MERRICK RD, SUITE 128W, ROCKVILLE CENTRE, NY 11570-4800
(516) 255-9031
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
002178
CT
363AS0400X
Surgical Physician Assistant
Primary
012806
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002178
CT LICENSE
CT
01
—
012806
NY LICENSE
NY
Enumeration date
10/09/2008
Last updated
08/31/2011
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