Provider Demographics
NPI:1700665411
Name:FERRARA, JENNA CATHERINE (OTR/L)
Entity type:Individual
Prefix:MISS
First Name:JENNA
Middle Name:CATHERINE
Last Name:FERRARA
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:356 TYLER AVE
Mailing Address - Street 2:
Mailing Address - City:MILLER PLACE
Mailing Address - State:NY
Mailing Address - Zip Code:11764-3430
Mailing Address - Country:US
Mailing Address - Phone:631-252-3992
Mailing Address - Fax:
Practice Address - Street 1:356 TYLER AVE
Practice Address - Street 2:
Practice Address - City:MILLER PLACE
Practice Address - State:NY
Practice Address - Zip Code:11764-3430
Practice Address - Country:US
Practice Address - Phone:631-252-3992
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-22
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028190225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist