Basic Information
| Provider Information | |||||||||
| NPI: | 1114294006 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HOPE PEDIATRICS PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3512 STATE ROUTE 257 | ||||||||
| Address2: | |||||||||
| City: | SENECA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 163462946 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8146773717 | ||||||||
| FaxNumber: | 8146778914 | ||||||||
| Practice Location | |||||||||
| Address1: | 3512 STATE ROUTE 257 | ||||||||
| Address2: | |||||||||
| City: | SENECA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 163462946 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8146773717 | ||||||||
| FaxNumber: | 8146778914 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/21/2011 | ||||||||
| LastUpdateDate: | 11/21/2011 | ||||||||
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| AuthorizedOfficialLastName: | HAMM | ||||||||
| AuthorizedOfficialFirstName: | GLENN | ||||||||
| AuthorizedOfficialMiddleName: | GORDON | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8146773717 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | MD029612E | PA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.