Healthcare Provider Details

I. General information

NPI: 1831251180
Provider Name (Legal Business Name): HYPERTENSION NEPHROLOGY ASSOCIATES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2006
Last Update Date: 03/23/2022
Certification Date: 03/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

735 FITZWATERTOWN RD
WILLOW GROVE PA
19090-1338
US

IV. Provider business mailing address

735 FITZWATERTOWN RD
WILLOW GROVE PA
19090-1332
US

V. Phone/Fax

Practice location:
  • Phone: 215-657-2019
  • Fax: 215-657-2018
Mailing address:
  • Phone: 215-657-2012
  • Fax: 215-657-2018

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number
License Number State

VIII. Authorized Official

Name: INESSA PARKANSKY
Title or Position: MD
Credential: MD
Phone: 215-657-2012