Rena Ferguson, Md, Pc | |
128 Old Town Rd Suite C & D Setauket NY 11733-2064 | |
(631) 689-5390 | |
(631) 689-5395 |
Full Name | Rena Ferguson, Md, Pc |
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Speciality | Psychiatry & Neurology |
Location | 128 Old Town Rd, Setauket, New York |
Authorized Official Name and Position | George Gmytrasiewicz (CONSULTANT) |
Authorized Official Contact | 6316895390 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Rena Ferguson, Md, Pc 128 Old Town Rd Suite C & D Setauket NY 11733-2064 Ph: (631) 689-5390 | Rena Ferguson, Md, Pc 128 Old Town Rd Suite C & D Setauket NY 11733-2064 Ph: (631) 689-5390 |
NPI Number | 1477703924 |
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Provider Enumeration Date | 09/21/2008 |
Last Update Date | 10/14/2008 |
Medicare PECOS PAC ID | 9537237888 |
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Medicare Enrollment ID | O20081014000306 |
Identifier | Type | State | Issuer |
---|---|---|---|
1477703924 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084P0800X | Psychiatry & Neurology - Psychiatry | 230330 (New York) | Primary |
Provider Name | Rena K Ferguson |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1013082452 PECOS PAC ID: 2961498498 Enrollment ID: I20040421001164 |
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