Active NPI
Christine Ferandos Petrozzino, MD
- Pediatrics Physician
- Blackwood, NJ
National Provider Identifier
1013182245
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 25MA09640300
- Practice address
- 535 S Black Horse Pike
Blackwood, NJ 08012-2807 - Phone
- (856) 228-1061
- Fax
- (856) 228-1907
- NPI assigned
- Apr 29, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 25MA09640300 | NJ | Primary |
Addresses
Primary practice location
535 S Black Horse Pike
Blackwood, NJ 08012-2807
Mailing address
535 S Black Horse Pike
Blackwood, NJ 08012-2807
Phone (856) 228-1061
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ME 102029 | Other | FL | FL STATE DEPARTMENT OF HEALTH |
| AFE 89730 (RETIRED) | Other | CA | MEDICAL BOARD OF CALIFORNIA |
Other names 1
- Christine Ferandos
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA09640300 | NJ | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1209427200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1013182245",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "535 S BLACK HORSE PIKE",
"city": "BLACKWOOD",
"state": "NJ",
"postal_code": "080122807",
"telephone_number": "856-228-1061",
"fax_number": "856-228-1907"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "535 S BLACK HORSE PIKE",
"city": "BLACKWOOD",
"state": "NJ",
"postal_code": "080122807",
"telephone_number": "856-228-1061",
"fax_number": "856-228-1907"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETROZZINO",
"first_name": "CHRISTINE",
"middle_name": "FERANDOS",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-04-29",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NJ",
"license": "25MA09640300",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FL STATE DEPARTMENT OF HEALTH",
"identifier": "ME 102029",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL BOARD OF CALIFORNIA",
"identifier": "AFE 89730 (RETIRED)",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "CHRISTINE",
"last_name": "FERANDOS",
"credential": "MD",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Blackwood, NJ
- Perry J Cicchini DC PA
- Marcella Perry
- Personalized Independent Living Opporuntities & Training Services
- Personalized Independent Living Opporuntities & Training Services
- Maria Petrongolo, DPT
- Pharmatech Consulting Group, LLC
- Philadelphia Health & Education Corp
- Philadelphia Health & Education Corporation
- Delia Marie Pierson, P.T.A.
- Alexa Paige Plitt, OTR/L
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.