Individual
MR. NEIL CULLEN HEFFERNAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1111 EASTEND BLVD, WILKES-BARRE, PA 18711
(570) 824-3521
Mailing address
30 FARMHOUSE RD, MOUNTAIN TOP, PA 18707-1725
(570) 474-6249
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
MA001791L
PA
Other
Enumeration date
07/26/2006
Last updated
07/09/2007
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