Healthcare Provider Details

I. General information

NPI: 1912970567
Provider Name (Legal Business Name): SEAN JAMES HOPKINS PT, MS, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

358 MADISON ST
WATERVILLE NY
13480-1116
US

IV. Provider business mailing address

7619 STATE HIGHWAY 80
COOPERSTOWN NY
13326-3315
US

V. Phone/Fax

Practice location:
  • Phone: 315-841-3222
  • Fax: 315-841-4023
Mailing address:
  • Phone: 315-858-5494
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number024521
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: