Healthcare Provider Details

I. General information

NPI: 1588429252
Provider Name (Legal Business Name): NANCY FIGUEROA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/20/2024
Last Update Date: 02/20/2024
Certification Date: 02/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8145 TERRY ST
PHILADELPHIA PA
19136-2621
US

IV. Provider business mailing address

8145 TERRY ST
PHILADELPHIA PA
19136-2621
US

V. Phone/Fax

Practice location:
  • Phone: 215-678-9280
  • Fax:
Mailing address:
  • Phone: 215-678-9280
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247200000X
TaxonomyOther Technician
License Number831847
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: