Individual
IVA HODAJ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2100 BOWLER ST, PHILADELPHIA, PA 19115-3309
(215) 596-9387
Mailing address
2100 BOWLER ST, PHILADELPHIA, PA 19115-3309
(215) 596-9387
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
PA
Other
Enumeration date
01/21/2021
Last updated
01/21/2021
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