Provider Demographics
NPI:1598388654
Name:FERRIGAN, STEPHANIE ANNE (MD)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:ANNE
Last Name:FERRIGAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:711 TROY SCHENECTADY RD STE 203
Mailing Address - Street 2:
Mailing Address - City:LATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12110-2461
Mailing Address - Country:US
Mailing Address - Phone:518-782-3700
Mailing Address - Fax:518-782-3799
Practice Address - Street 1:501 NEW KARNER RD STE 1
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205-3874
Practice Address - Country:US
Practice Address - Phone:518-393-0391
Practice Address - Fax:518-372-3281
Is Sole Proprietor?:No
Enumeration Date:2020-05-24
Last Update Date:2023-06-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
390200000X
NY324019207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program