Individual
CARLESHA FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
98 WESTSIDE AVE, FREEPORT, NY 11520-5422
(516) 670-6328
Mailing address
98 WESTSIDE AVE, FREEPORT, NY 11520-5422
(516) 670-6328
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
683145-1
NY
Other
Enumeration date
06/06/2014
Last updated
06/06/2014
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