Basic Information
Provider Information
NPI: 1396996559
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FELDMAN
FirstName: HOPE
MiddleName:  
NamePrefix: MRS.
NameSuffix:  
Credential: CRNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4837 PULASKI AVE
Address2:  
City: PHILADELPHIA
State: PA
PostalCode: 191444128
CountryCode: US
TelephoneNumber: 2158439720
FaxNumber: 2158437313
Practice Location
Address1: 4700 WISSAHICKON AVE
Address2: BUILDING D SUITE 119
City: PHILADELPHIA
State: PA
PostalCode: 191444248
CountryCode: US
TelephoneNumber: 2158439720
FaxNumber: 2158437313
Other Information
ProviderEnumerationDate: 10/07/2008
LastUpdateDate: 01/06/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000XSP009890PAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

ID Information
IDTypeStateIssuerDescription
102228149000105PA MEDICAID


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