Individual
ALLISON IVY FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
341 COMMACK RD, COMMACK, NY 11725-3444
(631) 462-9077
Mailing address
29 STEVENSON PL, DEER PARK, NY 11729-2123
(631) 940-7608
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
043798
NY
Other
Enumeration date
02/10/2010
Last updated
02/10/2010
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