Provider Demographics
NPI:1538346234
Name:CYNTHIA S FERRELLI PLLC
Entity type:Organization
Organization Name:CYNTHIA S FERRELLI PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DPM
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:FERRELLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-631-1133
Mailing Address - Street 1:330 HARRIS HILL RD STE B
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-7407
Mailing Address - Country:US
Mailing Address - Phone:716-631-1133
Mailing Address - Fax:
Practice Address - Street 1:330 HARRIS HILL RD STE B
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-7407
Practice Address - Country:US
Practice Address - Phone:716-631-1133
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-24
Last Update Date:2008-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0046741332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01215118Medicaid
NY279943Medicare PIN
NY0996190001Medicare NSC
NY01215118Medicaid