Provider Demographics
NPI:1497813570
Name:TROY, SOPHIE P (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:SOPHIE
Middle Name:P
Last Name:TROY
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8322 BELLONA AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-2065
Mailing Address - Country:US
Mailing Address - Phone:410-337-8847
Mailing Address - Fax:410-337-5189
Practice Address - Street 1:8322 BELLONA AVE STE 100
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-2065
Practice Address - Country:US
Practice Address - Phone:410-337-8847
Practice Address - Fax:410-337-5189
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC010613225X00000X
MD04616225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PACK4276OtherPALMETTO GBA RR MEDICARE
PA0068377000OtherAMERIHEALTH UNDER IBC
PA1875149OtherHIGHMARK BLUESHIELD
PA03182100OtherCAPITAL BLUE CROSS
PA18444OtherHEALTH AMERICA
PA177124OtherMEDICARE HGS ADMINISTRATORS
MD04616OtherOT LICENSE
PA0197900001Medicare NSC