Healthcare Provider Details

I. General information

NPI: 1932044468
Provider Name (Legal Business Name): STEVEN L COOPER SR. P.T.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2026
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1130 NORTH CHARLES STREET
BALTIMORE MD
21201
US

IV. Provider business mailing address

1130 NORTH CHARLES STREET
BALTIMORE MD
21201
US

V. Phone/Fax

Practice location:
  • Phone: 410-685-7790
  • Fax: 410-685-7851
Mailing address:
  • Phone: 410-685-7790
  • Fax: 410-685-7851

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberA1840
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: