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General NPI Number Information
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NPI Number | 1013082452
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Entity Type | Individual
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Provider Name | RENA K FERGUSON MD
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Gender | Female
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Dates
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Enumeration Date | 11/21/2006
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Last Update Date | 02/09/2026
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Provider Practice Location Address
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Address Line | 251 E OAKLAND AVE STE 2A
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City | PORT JEFFERSON
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State | NY
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Zip | 11777-2602
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Country | US
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Telephone | 631-760-1830
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Fax | 631-509-6080
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Provider Business Mailing Address
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Address Line | 251 E OAKLAND AVE STE 2A
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City | PORT JEFFERSON
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State | NY
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Zip | 11777-2602
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Country | US
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Telephone | 631-760-1830
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Fax | 631-509-6080
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 230330
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License Number State | NY
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