Healthcare Provider Details

I. General information

NPI: 1942905054
Provider Name (Legal Business Name): MIRANDA P. FIGUEROA DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MIRANDA PATRICIA PENN D.O.

II. Dates (important events)

Enumeration Date: 03/31/2023
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

239 HURFFVILLE CROSSKEYS RD STE 460
SEWELL NJ
08080-4009
US

IV. Provider business mailing address

301 LIPPINCOTT DR STE 410
MARLTON NJ
08053-4197
US

V. Phone/Fax

Practice location:
  • Phone: 856-341-8181
  • Fax: 856-341-8180
Mailing address:
  • Phone: 856-341-8181
  • Fax: 856-341-8180

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number25MB13029100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: