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General NPI Number Information
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NPI Number | 1144590563
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Entity Type | Individual
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Provider Name | KATHLEEN ANNE HOPE DPM
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Gender | Female
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Dates
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Enumeration Date | 01/02/2012
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Last Update Date | 06/15/2016
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Provider Practice Location Address
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Address Line | 325 BLUE VALLEY DR
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City | BANGOR
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State | PA
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Zip | 18013-1526
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Country | US
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Telephone | 610-588-6621
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Fax | 610-588-6307
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Provider Business Mailing Address
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Address Line | 325 BLUE VALLEY DR
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City | BANGOR
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State | PA
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Zip | 18013-1526
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Country | US
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Telephone | 610-588-6621
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Fax | 610-588-6307
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 25MD00311700
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | SC006196
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License Number State | PA
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