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General NPI Number Information
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NPI Number | 1588155634
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Entity Type | Individual
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Provider Name | CAITLIN FERGUSON PA-C
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Gender | Female
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Dates
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Enumeration Date | 05/24/2018
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Last Update Date | 07/03/2020
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Provider Practice Location Address
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Address Line | 41 E POST RD
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City | WHITE PLAINS
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State | NY
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Zip | 10601-4607
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Country | US
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Telephone | 914-681-0600
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Fax |
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Provider Business Mailing Address
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Address Line | 65 AUNT HACK RD
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City | DANBURY
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State | CT
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Zip | 06811-2720
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Country | US
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Telephone | 914-406-5242
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Fax |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 4351
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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