Individual
KENNETH J HUEFTLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSPAS, PA-C
Contact information
Practice address
2301 S BROAD ST, PHILADELPHIA, PA 19148-3542
(609) 680-8160
Mailing address
1333 FAWN DR, WILLIAMSTOWN, NJ 08094-3488
(609) 680-8160
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA057501
PA
363AM0700X
Medical Physician Assistant
OA003525
PA
363AM0700X
Medical Physician Assistant
—
NJ
Other
Enumeration date
09/11/2013
Last updated
11/12/2019
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