Provider Demographics
NPI:1285747758
Name:HOPCHIK, JORDAN (CRNP)
Entity type:Individual
Prefix:DR
First Name:JORDAN
Middle Name:
Last Name:HOPCHIK
Suffix:
Gender:M
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:824 N BLACK HORSE PIKE
Mailing Address - Street 2:
Mailing Address - City:RUNNEMEDE
Mailing Address - State:NJ
Mailing Address - Zip Code:08078-1034
Mailing Address - Country:US
Mailing Address - Phone:856-939-5656
Mailing Address - Fax:
Practice Address - Street 1:824 N BLACK HORSE PIKE
Practice Address - Street 2:
Practice Address - City:RUNNEMEDE
Practice Address - State:NJ
Practice Address - Zip Code:08078-1034
Practice Address - Country:US
Practice Address - Phone:856-939-5656
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP007813363L00000X, 363LF0000X, 363LF0000X
NJ26NJ00233000363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner