Individual
AMBER C FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1439 SOUTH ST, LAKEWOOD, NJ 08701-5440
(732) 523-2327
(732) 544-0364
Mailing address
1439 SOUTH ST, LAKEWOOD, NJ 08701-5440
(347) 453-1935
Taxonomy
Speciality
Code
Description
License number
State
374700000X
Technician
Primary
1740800713
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1740800713
TECHNICIAN
NY
Enumeration date
12/15/2020
Last updated
12/15/2020
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