1093730194 NPI number — DR. CHRISTOPHER J FERGUSON DPM

Table of content: DR. CHRISTOPHER J FERGUSON DPM (NPI 1093730194)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093730194 NPI number — DR. CHRISTOPHER J FERGUSON DPM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FERGUSON
Provider First Name:
CHRISTOPHER
Provider Middle Name:
J
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DPM
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1093730194
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/03/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2900 HEMPSTEAD TPKE
Provider Second Line Business Mailing Address:
SUITE 103
Provider Business Mailing Address City Name:
LEVITTOWN
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11756-1404
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
516-579-2800
Provider Business Mailing Address Fax Number:
516-520-9037

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2900 HEMPSTEAD TPKE
Provider Second Line Business Practice Location Address:
SUITE 103
Provider Business Practice Location Address City Name:
LEVITTOWN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11756-1404
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
516-579-2800
Provider Business Practice Location Address Fax Number:
516-520-9037
Provider Enumeration Date:
07/12/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 213ES0103X , with the licence number:  N005810 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 7769451 . This is a "AETNA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: MAGNACARE . This is a "030474207" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 02413629 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 030474207 . This is a "HORIZON HEALTHCARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 3C5966 . This is a "HEALTHNET" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: P2724913 . This is a "OXFORD" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1400232 . This is a "GHI" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 2853553-003 . This is a "CIGNA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 2325593 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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