Provider Demographics
NPI:1750441838
Name:FERDICO, PETER
Entity type:Individual
Prefix:MR
First Name:PETER
Middle Name:
Last Name:FERDICO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:97 STERLING PL
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:NY
Mailing Address - Zip Code:12528-2019
Mailing Address - Country:US
Mailing Address - Phone:845-834-3609
Mailing Address - Fax:
Practice Address - Street 1:1607 ROUTE 300
Practice Address - Street 2:SUITE 102
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-1738
Practice Address - Country:US
Practice Address - Phone:845-564-9853
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor