Basic Information
Provider Information
NPI: 1306836044
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FERRARO
FirstName: RICHARD
MiddleName: J
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1300 PICCARD DR
Address2: STE 202
City: ROCKVILLE
State: MD
PostalCode: 208504303
CountryCode: US
TelephoneNumber: 3019217900
FaxNumber: 3019217915
Practice Location
Address1: 1850 TOWN CENTER PKWY
Address2: RESTON HOSPITAL CENTER
City: RESTON
State: VA
PostalCode: 20190
CountryCode: US
TelephoneNumber: 7036899037
FaxNumber: 7036899109
Other Information
ProviderEnumerationDate: 10/25/2005
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: X
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000X0101237723VAY Allopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


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