Individual
EILEEN MORAN FERGUSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.P.A.
Contact information
Practice address
2301 S BROAD ST, PHILADELPHIA, PA 19148-3542
(215) 952-9155
(215) 952-5011
Mailing address
1217 IRIS AVE, WILLIAMSTOWN, NJ 08094-9516
(856) 262-8745
(856) 262-8745
Taxonomy
Speciality
Code
Description
License number
State
243U00000X
Radiology Practitioner Assistant
Primary
06NJ1211
NJ
Other
Enumeration date
10/05/2009
Last updated
10/05/2009
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