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NPI Code Detail

MEDICARE: WILLIAM SOPKO JR. MSOTR/L,FMT, ATP,CLT

MEDICARE: WILLIAM SOPKO JR. MSOTR/L,FMT, ATP,CLT
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
1225X00000XOccupational TherapistOC013972PA
2225X00000XOccupational TherapistU1-0001622DE

General Provider Information

NPI Number : 1477254647
Entity Type Code : Individual
Provider Name (Legal Business Name) : WILLIAM SOPKO JR. MSOTR/L,FMT, ATP,CLT
Provider Business Mailing Address
First Line : 1423 FRESNO RD
Second Line :
City : WILMINGTON
State : DE
Zip : 19803-5121
Country : US
Telephone Number : 610-715-2949
Fax Number :
Provider Business Practice Location Address
First Line : 1072 JUSTISON ST
Second Line :
City : WILMINGTON
State : DE
Zip : 19801-5162
Country : US
Telephone Number : 302-660-3387
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/15/2023
Last Update Date : 03/15/2023

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