Basic Information
| Provider Information | |||||||||
| NPI: | 1639299464 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HOPKINSON | ||||||||
| FirstName: | STEPHANIE | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 725 RESERVOIR AVENUE | ||||||||
| Address2: | #101 | ||||||||
| City: | CRANSTON | ||||||||
| State: | RI | ||||||||
| PostalCode: | 02910 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4019443800 | ||||||||
| FaxNumber: | 4019433129 | ||||||||
| Practice Location | |||||||||
| Address1: | 2138 MENDON ROAD | ||||||||
| Address2: | |||||||||
| City: | CUMBERLAND | ||||||||
| State: | RI | ||||||||
| PostalCode: | 02864 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4013341060 | ||||||||
| FaxNumber: | 4013341063 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/29/2007 | ||||||||
| LastUpdateDate: | 01/29/2010 | ||||||||
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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 | 225100000X | 277 | RI | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 225100000X | PT00277 | RI | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
ID Information
| ID | Type | State | Issuer | Description | 1639299464 | 01 | RI | DURABLE | OTHER | RI277 | 01 | RI | RHODE ISLAND LICENSE | OTHER | 24175 | 01 | RI | BLUE CROSS BLUE SHIELD | OTHER | 407262 | 01 | RI | BLUE CHIP | OTHER | 6400017 | 01 | RI | UNITED HEALTH CARE | OTHER |