Provider Demographics
NPI:1396081691
Name:HOPKINS, KRYSTA MARIE (DPT)
Entity type:Individual
Prefix:
First Name:KRYSTA
Middle Name:MARIE
Last Name:HOPKINS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:KRYSTA
Other - Middle Name:M
Other - Last Name:MORACZEWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:833 CHESTNUT ST
Mailing Address - Street 2:SUITE 1402
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-4414
Mailing Address - Country:US
Mailing Address - Phone:800-321-9999
Mailing Address - Fax:267-339-3761
Practice Address - Street 1:327 GREENTREE RD
Practice Address - Street 2:
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080-9229
Practice Address - Country:US
Practice Address - Phone:856-286-4224
Practice Address - Fax:856-286-4269
Is Sole Proprietor?:No
Enumeration Date:2012-12-14
Last Update Date:2015-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01475100225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist