Individual
MS. COURTNEY GEIS ERCOLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5458 RIDGE AVE, PHILADELPHIA, PA 19128-3732
(215) 487-1887
Mailing address
2226 GREEN ST, PHILADELPHIA, PA 19130-3113
(215) 563-4140
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA056086
PA
Other
Enumeration date
05/02/2013
Last updated
05/02/2013
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