Provider Demographics
NPI:1710970108
Name:FERRELLI, CYNTHIA S (DPM)
Entity type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:S
Last Name:FERRELLI
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 HARRIS HILL RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14221-7407
Mailing Address - Country:US
Mailing Address - Phone:716-631-1133
Mailing Address - Fax:716-631-3030
Practice Address - Street 1:330 HARRIS HILL RD
Practice Address - Street 2:SUITE B
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14221-7407
Practice Address - Country:US
Practice Address - Phone:716-631-1133
Practice Address - Fax:716-631-3030
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-31
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYNY0046741213E00000X
NYNY004674-1213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
BC ROCHESTEROtherP01004674
MCR SHOE PROGRAMOther0996190001
P046749BOtherWORKERS COMP
00052799400OtherBC ORTHOTICS ETC
0892504OtherAETNA US HEALTHCARE
0004413215OtherAETNA EL PASO TX
NY01215118Medicaid
GHIOther6200202
NY5279945OtherCB ORTHOTIC PROVIDER #
00010252502OtherUNIVERA AND SENIOR CHOICE
P6348OtherEMPIRE BCBS
8990329OtherIHA
00010252502OtherUNIVERA AND SENIOR CHOICE
NY279943Medicare ID - Type Unspecified