Provider Demographics
NPI:1760583181
Name:HODOROWICZ, BRITTANY A H (PA-C)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:A H
Last Name:HODOROWICZ
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2605 BLUE RIDGE RD
Mailing Address - Street 2:STE 240
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27607-6475
Mailing Address - Country:US
Mailing Address - Phone:919-277-9845
Mailing Address - Fax:919-863-9850
Practice Address - Street 1:3001 EDWARDS MILL RD
Practice Address - Street 2:STE 200
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-5243
Practice Address - Country:US
Practice Address - Phone:919-781-5600
Practice Address - Fax:919-782-6578
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2018-10-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC0010-00724363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2331955OtherMEDICARE GRP PIN
NC2331955OtherMEDICARE GRP PIN