Organization
LEWISTON VILLAGE PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SHAWN P FERGUSON M.D. (PRESIDENT)
(716) 754-7337
Entity
Organization
Contact information
Practice address
733 CENTER STREET, LEWISTON, NY 14092
(716) 754-7337
(716) 754-2041
Mailing address
733 CENTER STREET, LEWISTON, NY 14092
(716) 754-7337
(716) 754-2041
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
131077
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00586883
—
NY
05
—
00968483
—
NY
05
—
01827458
—
NY
05
—
07152689
—
NY
Enumeration date
09/21/2006
Last updated
08/04/2016
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