Provider Demographics
NPI:1720362064
Name:FERGUSON, RUTH (MD)
Entity Type:Individual
Prefix:DR
First Name:RUTH
Middle Name:
Last Name:FERGUSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:RUTH
Other - Middle Name:FERGUSON
Other - Last Name:RICHARDS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:20 PECONIC BAY AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTHAMPTON
Mailing Address - State:NY
Mailing Address - Zip Code:11968-1221
Mailing Address - Country:US
Mailing Address - Phone:631-283-4079
Mailing Address - Fax:
Practice Address - Street 1:20 PECONIC BAY AVE
Practice Address - Street 2:
Practice Address - City:SOUTHAMPTON
Practice Address - State:NY
Practice Address - Zip Code:11968-1221
Practice Address - Country:US
Practice Address - Phone:631-283-4079
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-05
Last Update Date:2011-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY091188-1208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice