Individual
MRS. CAVEL FREDRICKA MCLEAN FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
4369 MATILDA AVE, BRONX, NY 10466-1316
(347) 784-6962
Mailing address
4369 MATILDA AVE, BRONX, NY 10466-1316
(347) 784-6962
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
316250
NY
Other
Enumeration date
10/29/2013
Last updated
10/29/2013
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