Provider Demographics
NPI:1912515545
Name:ZOPHY, ELLEN
Entity type:Individual
Prefix:
First Name:ELLEN
Middle Name:
Last Name:ZOPHY
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:ELLEN
Other - Middle Name:J
Other - Last Name:ZOPHY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:500 UNIVERSITY DR MC CA410
Mailing Address - Street 2:
Mailing Address - City:HERSHEY
Mailing Address - State:PA
Mailing Address - Zip Code:17033-2360
Mailing Address - Country:US
Mailing Address - Phone:717-531-5208
Mailing Address - Fax:717-531-0119
Practice Address - Street 1:503 N 21ST ST
Practice Address - Street 2:
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-2204
Practice Address - Country:US
Practice Address - Phone:717-763-2100
Practice Address - Fax:717-975-2724
Is Sole Proprietor?:No
Enumeration Date:2020-07-20
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA58745363A00000X
PAMA066355363A00000X
TXPA15604363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant