Individual
STACY MARIA FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
175 CROSS KEYS RD, BERLIN, NJ 08009-9263
(856) 767-0077
(856) 767-0100
Mailing address
401 N KIRKWOOD AVE, STRATFORD, NJ 08084-1163
(856) 261-3619
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00179700
NJ
Other
Enumeration date
05/22/2007
Last updated
05/16/2011
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