Provider Demographics
NPI:1700936739
Name:SELARNICK, HOPE SUSAN (MD)
Entity Type:Individual
Prefix:DR
First Name:HOPE
Middle Name:SUSAN
Last Name:SELARNICK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1428 WOLF ST
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19145-4448
Mailing Address - Country:US
Mailing Address - Phone:215-271-4130
Mailing Address - Fax:215-271-4130
Practice Address - Street 1:1428 WOLF ST
Practice Address - Street 2:1ST FLOOR
Practice Address - City:PHILA
Practice Address - State:PA
Practice Address - Zip Code:19145-4448
Practice Address - Country:US
Practice Address - Phone:215-271-4130
Practice Address - Fax:215-271-4130
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2008-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD037117E2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1307254Medicaid
PAF44399Medicare UPIN
PA1307254Medicaid