Healthcare Provider Details

I. General information

NPI: 1942114673
Provider Name (Legal Business Name): JOEL ISAIAH HURDLE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 WALNUT ST STE 100
LANSDALE PA
19446-1144
US

IV. Provider business mailing address

PO BOX 56011
PHILADELPHIA PA
19130-6011
US

V. Phone/Fax

Practice location:
  • Phone: 267-263-2246
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: