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Individual

MRS. AMBER LORRAINE FERGUSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
R.PH

Contact information

Practice address
4765 COMMERCIAL DR, NEW HARTFORD, NY 13413-6211
(315) 736-6822
Mailing address
4765 COMMERCIAL DR, NEW HARTFORD, NY 13413-6211
(315) 736-6822

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
049206
NY
183500000X
Pharmacist
28RI03075600
NJ
183500000X
Pharmacist
RP440247
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
049206
NY STATE PHARMACY LICENSE
NY
01
28RI03075600
NJ PHARMACY LICENSE
NJ
01
RP440247
PA PHARMACY LICENSE
PA
Enumeration date
12/27/2007
Last updated
01/26/2009
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