Provider Demographics
NPI:1316995947
Name:KOPCHA, ERICA (MOT, OTR/L)
Entity type:Individual
Prefix:MS
First Name:ERICA
Middle Name:
Last Name:KOPCHA
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 W 10TH ST
Mailing Address - Street 2:
Mailing Address - City:MARCUS HOOK
Mailing Address - State:PA
Mailing Address - Zip Code:19061-4513
Mailing Address - Country:US
Mailing Address - Phone:610-859-8850
Mailing Address - Fax:610-859-7876
Practice Address - Street 1:8019 FRANKFORD AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19136-2786
Practice Address - Country:US
Practice Address - Phone:215-338-8900
Practice Address - Fax:215-338-8923
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2010-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC-009140225X00000X
DEU1-0001110225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
306169OtherUNISON
PA1316995947OtherBRAVO
PA1749958OtherHIGHMARK PA BLUE SHIELD
PA30056540OtherKEYSTONE MERCY
1316995947OtherDELAWARE PHYSICIANS CARE
2415419000OtherIBC PERSONAL CHOICE
PA1023730790001Medicaid
PAP00713323OtherMEDICARE RR
PA133730VLZMedicare PIN