Basic Information
| Provider Information | |||||||||
| NPI: | 1770724296 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FERRENZ | ||||||||
| FirstName: | ELIZABETH | ||||||||
| MiddleName: | EIDEANN | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 771 ALBANY ST | ||||||||
| Address2: | DOWLING 5 SOUTH | ||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021182525 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6174146235 | ||||||||
| FaxNumber: | 6174143345 | ||||||||
| Practice Location | |||||||||
| Address1: | 850 HARRISON AVE | ||||||||
| Address2: | YAWKEY ACC 3 | ||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021184001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6174142080 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/12/2009 | ||||||||
| LastUpdateDate: | 12/28/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 249335 | MA | Y | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | A106849 | CA | N | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.