Healthcare Provider Details

I. General information

NPI: 1932936622
Provider Name (Legal Business Name): LAURA RAMONA HOPIRTEAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2024
Last Update Date: 09/17/2024
Certification Date: 09/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 STATE ROUTE 73 NORTH
MARLTON NJ
08053
US

IV. Provider business mailing address

525 STATE ROUTE 73 NORTH
MARLTON NJ
08053
US

V. Phone/Fax

Practice location:
  • Phone: 833-494-6724
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number26NJ15114700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: