Healthcare Provider Details

I. General information

NPI: 1396777199
Provider Name (Legal Business Name): JUDY FINGERGUT M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 04/16/2025
Certification Date: 04/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28 CENTRE DR
MILTON VT
05468-3104
US

IV. Provider business mailing address

181 BELLE MEAD RD SUITE 2
EAST SETAUKET NY
11733-3495
US

V. Phone/Fax

Practice location:
  • Phone: 802-847-4322
  • Fax:
Mailing address:
  • Phone: 631-444-5858
  • Fax: 631-444-5854

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number206374
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number042.0013862
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: