Individual
JACQUELINE SHERRY FERN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2 MEDICAL DR, SUITE A, PORT JEFFERSON STATION, NY 11776-1598
(631) 928-1555
(631) 928-1570
Mailing address
2 MEDICAL DR, SUITE A, PORT JEFFERSON STATION, NY 11776-1598
(631) 928-1555
(631) 928-1570
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
175358
NY
Other
Enumeration date
12/07/2005
Last updated
05/22/2014
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