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General NPI Number Information
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NPI Number | 1922442615
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Entity Type | Individual
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Provider Name | ALLISON ANN SOPKO MD
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Gender | Female
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Dates
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Enumeration Date | 04/24/2013
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Last Update Date | 07/12/2018
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Provider Practice Location Address
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Address Line | 195 COLUMBIA TPKE STE 105
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City | FLORHAM PARK
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State | NJ
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Zip | 07932
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Country | US
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Telephone | 973-437-8300
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Fax | 973-845-2883
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Provider Business Mailing Address
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Address Line | 195 COLUMBIA TPKE STE 105
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City | FLORHAM PARK
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State | NJ
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Zip | 07932-2254
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 25MA09258100
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License Number State | NJ
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