Basic Information
Provider Information | |||||||||
NPI: | 1831113992 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | FERRY | ||||||||
FirstName: | FRANCIS | ||||||||
MiddleName: | THOMAS | ||||||||
NamePrefix: | DR. | ||||||||
NameSuffix: |   | ||||||||
Credential: | MD | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: | FERRY | ||||||||
OtherFirstName: | FRANK | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: | 5 | ||||||||
Mailing Information | |||||||||
Address1: | P.O. BOX 191 | ||||||||
Address2: |   | ||||||||
City: | ROCKLAND | ||||||||
State: | DE | ||||||||
PostalCode: | 197230191 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 3026514000 | ||||||||
FaxNumber: | 3026514945 | ||||||||
Practice Location | |||||||||
Address1: | 1 E NEW YORK AVE | ||||||||
Address2: | SHORE MEMORIAL HOSPITAL INPATIENT PEDIATRICS SERVICE | ||||||||
City: | SOMERS POINT | ||||||||
State: | NJ | ||||||||
PostalCode: | 082442340 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 6099264258 | ||||||||
FaxNumber: | 6096533727 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 07/26/2006 | ||||||||
LastUpdateDate: | 02/08/2017 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | M | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 25MA04064800 | NJ | Y |   | Allopathic & Osteopathic Physicians | Pediatrics |   | 208000000X | MD027636E | PA | N |   | Allopathic & Osteopathic Physicians | Pediatrics |   | 208000000X | D25889 | MD | N |   | Allopathic & Osteopathic Physicians | Pediatrics |   |
ID Information
ID | Type | State | Issuer | Description | 001774123 | 05 | NJ |   | MEDICAID | 4885601 | 05 | NJ |   | MEDICAID |