MEDICARE: SOPHIA ELAINE BALL PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1457145724
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SOPHIA ELAINE BALL PA-C

Provider Business Mailing Address
First Line	:	5 HILLCREST CIR
Second Line	:
City	:	NEW HOPE
State	:	PA
Zip	:	18938-5603
Country	:	US
Telephone Number	:	215-262-8514
Fax Number	:

Provider Business Practice Location Address
First Line	:	278 COURT ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11231-4432
Country	:	US
Telephone Number	:	212-385-3700
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/09/2025
Last Update Date	:	04/09/2025

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