Individual
MS. ALYSA FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD CDN
Contact information
Practice address
82 MIDDLE COUNTRY RD, CORAM, NY 11727-4411
(631) 854-2333
Mailing address
423 GRIFFING AVE, STE. 100, RIVERHEAD, NY 11901-3056
(631) 727-7850
(631) 727-7130
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
0061761
NY
Other
Enumeration date
09/11/2006
Last updated
08/27/2007
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