Provider Demographics
NPI:1861757858
Name:STODDART, HOPE (PA-C)
Entity type:Individual
Prefix:
First Name:HOPE
Middle Name:
Last Name:STODDART
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:HOPE
Other - Middle Name:
Other - Last Name:GRATZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:PO BOX 824031
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19182-4031
Mailing Address - Country:US
Mailing Address - Phone:610-459-3278
Mailing Address - Fax:
Practice Address - Street 1:1572 WILMINGTON PIKE
Practice Address - Street 2:SUITE 1
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19382-8371
Practice Address - Country:US
Practice Address - Phone:866-955-6774
Practice Address - Fax:781-280-6410
Is Sole Proprietor?:No
Enumeration Date:2012-07-06
Last Update Date:2012-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA055600363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant