Provider Demographics
NPI:1366893596
Name:FERGUSON, ARICA N (PA)
Entity type:Individual
Prefix:MRS
First Name:ARICA
Middle Name:N
Last Name:FERGUSON
Suffix:
Gender:F
Credentials:PA
Other - Prefix:MS
Other - First Name:ARICA
Other - Middle Name:N
Other - Last Name:NAVAIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:140 CANAL VIEW BLVD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14623
Mailing Address - Country:US
Mailing Address - Phone:585-279-5100
Mailing Address - Fax:585-424-1008
Practice Address - Street 1:140 CANAL VIEW BLVD
Practice Address - Street 2:SUITE 103
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623
Practice Address - Country:US
Practice Address - Phone:585-279-5100
Practice Address - Fax:585-424-1008
Is Sole Proprietor?:No
Enumeration Date:2016-06-29
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY19788363AS0400X
363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical