Basic Information
| Provider Information | |||||||||
| NPI: | 1497813570 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TROY | ||||||||
| FirstName: | SOPHIE | ||||||||
| MiddleName: | P | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | OTR/L | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8322 BELLONA AVE STE 100 | ||||||||
| Address2: | |||||||||
| City: | TOWSON | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212042065 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4103378847 | ||||||||
| FaxNumber: | 4103375189 | ||||||||
| Practice Location | |||||||||
| Address1: | 8322 BELLONA AVE STE 100 | ||||||||
| Address2: | |||||||||
| City: | TOWSON | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212042065 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4103378847 | ||||||||
| FaxNumber: | 4103375189 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/04/2006 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | OC010613 | PA | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | 225X00000X | 04616 | MD | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
ID Information
| ID | Type | State | Issuer | Description | CK4276 | 01 | PA | PALMETTO GBA RR MEDICARE | OTHER | 0068377000 | 01 | PA | AMERIHEALTH UNDER IBC | OTHER | 1875149 | 01 | PA | HIGHMARK BLUESHIELD | OTHER | 03182100 | 01 | PA | CAPITAL BLUE CROSS | OTHER | 18444 | 01 | PA | HEALTH AMERICA | OTHER | 177124 | 01 | PA | MEDICARE HGS ADMINISTRATORS | OTHER | 04616 | 01 | MD | OT LICENSE | OTHER |