Provider Demographics
NPI:1295018554
Name:BALOGUN, RONYA (RPH, LAPC, MA)
Entity type:Individual
Prefix:
First Name:RONYA
Middle Name:
Last Name:BALOGUN
Suffix:
Gender:F
Credentials:RPH, LAPC, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3845 BERKLEY RD
Mailing Address - Street 2:
Mailing Address - City:BENSALEM
Mailing Address - State:PA
Mailing Address - Zip Code:19020-1403
Mailing Address - Country:US
Mailing Address - Phone:908-216-6764
Mailing Address - Fax:215-253-5305
Practice Address - Street 1:4 INTERPLEX DR STE 101
Practice Address - Street 2:
Practice Address - City:FEASTERVILLE TREVOSE
Practice Address - State:PA
Practice Address - Zip Code:19053-6940
Practice Address - Country:US
Practice Address - Phone:908-216-6764
Practice Address - Fax:215-253-5305
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-23
Last Update Date:2025-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP450307183500000X
NJ28RI02688300183500000X
PAAPC001275101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional