| 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 |
|---|---|
| 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 |
|---|---|
| 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 |
|---|---|
| Provider Enumeration Date | 09/21/2008 |
| Last Update Date | 10/14/2008 |
| Medicare PECOS PAC ID | 9537237888 |
|---|---|
| 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 |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1013082452 PECOS PAC ID: 2961498498 Enrollment ID: I20040421001164 |
| Provider Name | Susan Walton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740601699 PECOS PAC ID: 6800134644 Enrollment ID: I20190220002505 |
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