Individual
AMANDA ROSE FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
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
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
063449
NY
Other
Enumeration date
09/14/2017
Last updated
09/14/2017
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