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Organization
RENA FERGUSON, MD, PC
Active
Organization
RENA FERGUSON, MD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGE GMYTRASIEWICZ (CONSULTANT)
(631) 689-5390
Entity
Organization
Contact information
Practice address
128 OLD TOWN RD, SUITE C & D, SETAUKET, NY 11733-2064
(631) 689-5390
(631) 689-5395
Mailing address
128 OLD TOWN RD, SUITE C & D, SETAUKET, NY 11733-2064
(631) 689-5390
(631) 689-5395
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
230330
NY
Other
Enumeration date
09/21/2008
Last updated
10/14/2008
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