1912515545 NPI number — ELLEN ZOPHY

Table of content: ELLEN ZOPHY (NPI 1912515545)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912515545 NPI number — ELLEN ZOPHY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ZOPHY
Provider First Name:
ELLEN
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ZOPHY
Provider Other First Name:
ELLEN
Provider Other Middle Name:
J
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
PA-C
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1912515545
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/03/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
500 UNIVERSITY DR MC CA410
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HERSHEY
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17033-2360
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-531-5208
Provider Business Mailing Address Fax Number:
717-531-0119

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
503 N 21ST ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CAMP HILL
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17011-2204
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-763-2100
Provider Business Practice Location Address Fax Number:
717-975-2724
Provider Enumeration Date:
07/20/2020

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363A00000X , with the licence number:  58745 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363A00000X , with the licence number: MA066355 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363A00000X , with the licence number: PA15604 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)