Provider Demographics
NPI:1528527173
Name:FERRARA, MARCELLA JEANNE
Entity type:Individual
Prefix:
First Name:MARCELLA
Middle Name:JEANNE
Last Name:FERRARA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91 BACK RIVER RD
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110-6619
Mailing Address - Country:US
Mailing Address - Phone:603-289-5343
Mailing Address - Fax:
Practice Address - Street 1:115 NORTHEASTERN BLVD
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03062-1944
Practice Address - Country:US
Practice Address - Phone:603-289-5343
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-13
Last Update Date:2019-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH06044998101OtherNH HEALTHY FAMILIES