Individual
DR. EVETTE WEIL FERGUSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
535 E 70TH ST, NEW YORK, NY 10021-4872
(212) 774-7640
(212) 774-2880
Mailing address
535 E 70TH ST, NEW YORK, NY 10021-4872
(212) 774-7640
(212) 774-2880
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
234636
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
WANX81
MEDICARE GROUP PIN
NY
Enumeration date
11/21/2006
Last updated
10/22/2008
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