Provider Demographics
NPI:1730686783
Name:FERRIS, MELINDA JANE (RPH)
Entity type:Individual
Prefix:
First Name:MELINDA
Middle Name:JANE
Last Name:FERRIS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 PIERCE ST
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-4185
Mailing Address - Country:US
Mailing Address - Phone:614-975-6433
Mailing Address - Fax:
Practice Address - Street 1:150 PIERCE ST
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-4185
Practice Address - Country:US
Practice Address - Phone:614-975-6433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-06
Last Update Date:2018-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRPH.03223019-2183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist