Provider Demographics
NPI:1639299464
Name:HOPKINSON, STEPHANIE (PT)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:HOPKINSON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 RESERVOIR AVENUE
Mailing Address - Street 2:#101
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02910
Mailing Address - Country:US
Mailing Address - Phone:401-944-3800
Mailing Address - Fax:401-943-3129
Practice Address - Street 1:2138 MENDON ROAD
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:RI
Practice Address - Zip Code:02864
Practice Address - Country:US
Practice Address - Phone:401-334-1060
Practice Address - Fax:401-334-1063
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2010-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI277225100000X
RIPT00277225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI1639299464OtherDURABLE
RIRI277OtherRHODE ISLAND LICENSE
RI24175OtherBLUE CROSS BLUE SHIELD
RI407262OtherBLUE CHIP
RI6400017OtherUNITED HEALTH CARE