Individual
HEIDI HUDEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
1015 CHESTNUT ST STE 512, PHILADELPHIA, PA 19107-4305
(267) 479-4180
(215) 873-0201
Mailing address
207 N BROAD ST FL 3, PHILADELPHIA, PA 19107-1500
(267) 479-4142
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA051887
PA
363AM0700X
Medical Physician Assistant
MA051887
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1039678100001
—
PA
Enumeration date
08/26/2010
Last updated
04/27/2022
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