DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: GLENN EUGENE FERGUSON PHD

MEDICARE: GLENN EUGENE FERGUSON PHD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical PsychologistPSY.0004552CO
2103TC0700XClinical Psychologist44SI00428700NJ
3103TC0700XClinical PsychologistPSY-2022-0061NM

General Provider Information

NPI Number : 1922391994
Entity Type Code : Individual
Provider Name (Legal Business Name) : GLENN EUGENE FERGUSON PHD
Provider Business Mailing Address
First Line : PO BOX 1595
Second Line :
City : MIDDLETOWN
State : CT
Zip : 06457-8095
Country : US
Telephone Number : 860-788-6404
Fax Number :
Provider Business Practice Location Address
First Line : 206 S CORONADO AVE
Second Line :
City : ESPANOLA
State : NM
Zip : 87532-2792
Country : US
Telephone Number : 860-788-6404
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2011
Last Update Date : 07/08/2024

Similar Medicare Providers

1497395396 — ABBAS KHAN
Practice Location Address:
206 S CORONADO AVE
ESPANOLA, NM
87532-2792
Practice Phone: 860-788-6404
Practice Fax:
1033355284 — DR. KEITH BRYAN HAYNIE DNP, RN, CFNP
Practice Location Address:
206 S CORONADO AVE
ESPANOLA, NM
87532-2792
Practice Phone: 860-788-6404
Practice Fax: 860-398-6441
1962944926 — CAREY MICHAEL REED APN
Practice Location Address:
206 S CORONADO AVE
ESPANOLA, NM
87532-2792
Practice Phone: 860-788-6404
Practice Fax:
1629639729 — MEDITELECARE OF NEW MEXICO, LLC
Practice Location Address:
206 S CORONADO AVE
ESPANOLA, NM
87532-2792
Practice Phone: 860-788-6404
Practice Fax:
1598352015 — CURANA HEALTH OF NEW MEXICO LLC
Practice Location Address:
206 S CORONADO AVE
ESPANOLA, NM
87532-2792
Practice Phone: 337-991-9276
Practice Fax:
1699407742 — SURGIMON, LLC
Practice Location Address:
206 S CORONADO AVE
ESPANOLA, NM
87532-2792
Practice Phone: 412-406-7692
Practice Fax: 412-968-9113

Directions to “ GLENN EUGENE FERGUSON PHD” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.