Provider Demographics
NPI:1649388786
Name:FERNOW HOUSE CALLS, PC
Entity Type:Organization
Organization Name:FERNOW HOUSE CALLS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:LESLEY
Authorized Official - Middle Name:MONTGOMERY
Authorized Official - Last Name:FERNOW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-204-1068
Mailing Address - Street 1:18 COUNTRY RD
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06880-2525
Mailing Address - Country:US
Mailing Address - Phone:203-222-7506
Mailing Address - Fax:
Practice Address - Street 1:144 EAST AVE APT B201
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06851-5764
Practice Address - Country:US
Practice Address - Phone:203-204-1068
Practice Address - Fax:855-677-4650
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-28
Last Update Date:2015-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT044163207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty