Individual provider · Type 1 NPI

Hedy Lydia Siedarta

Primary Care Nurse Practitioner · Philadelphia, PA

NPI number 1659091437 Active

Practice location

6232 Market St
Philadelphia, PA 19139-2922

Mailing address

1800 S 13th St
Philadelphia, PA 19148-2126

Specialties and licenses

TaxonomyCodeLicense
Nurse Practitioner 363L00000XSP026217 (PA)
Adult Health Nurse Practitioner 363LA2200XSP026217 (PA)
Gerontology Nurse Practitioner 363LG0600XSP026217 (PA)
Primary Care Nurse Practitioner Primary 363LP2300XSP026217 (PA)

Primary Care Nurse Practitioner: Definition to come...

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About NPI 1659091437

Hedy Lydia Siedarta's National Provider Identifier is 1659091437, issued on Aug 31, 2022. The primary taxonomy on file is Primary Care Nurse Practitioner (363LP2300X), and the practice location is in Philadelphia, PA. The record was last updated on Sep 1, 2022.