Provider Demographics
NPI:1821632761
Name:KPODI, SAFI M (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:SAFI
Middle Name:M
Last Name:KPODI
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 GAITHER DR STE K
Mailing Address - Street 2:
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-1706
Mailing Address - Country:US
Mailing Address - Phone:610-365-1492
Mailing Address - Fax:
Practice Address - Street 1:725 E ERIE AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19134-1210
Practice Address - Country:US
Practice Address - Phone:215-427-6987
Practice Address - Fax:215-291-1715
Is Sole Proprietor?:No
Enumeration Date:2019-11-04
Last Update Date:2019-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAF07191248363LX0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0106XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerOccupational Health