Individual
CORNELIUS FURGUESON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1801 VINE ST, ROOM 149-MG, PHILADELPHIA, PA 19103-1117
(215) 868-5160
(215) 546-9564
Mailing address
1923 BAINBRIDGE ST, PHILADELPHIA, PA 19146-1430
(215) 868-5160
(215) 546-9564
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PS-008444-L
PA
Other
Enumeration date
01/27/2007
Last updated
01/22/2008
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