Provider Demographics
NPI:1285057026
Name:RUNQUIST, ERIC A (PA-C)
Entity type:Individual
Prefix:MR
First Name:ERIC
Middle Name:A
Last Name:RUNQUIST
Suffix:
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:695 US HIGHWAY 46
Mailing Address - Street 2:STE 400A
Mailing Address - City:FAIRFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07004-1568
Mailing Address - Country:US
Mailing Address - Phone:973-826-8291
Mailing Address - Fax:888-972-6480
Practice Address - Street 1:1201 NEWTOWN-LANGHORNE RD
Practice Address - Street 2:ST MARY MEDICAL CENTER OPERATING ROOM
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1306
Practice Address - Country:US
Practice Address - Phone:215-710-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-30
Last Update Date:2018-07-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMA001381L363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical