Provider Demographics
NPI:1932225406
Name:HOPONICK, KATIE B (LPTA)
Entity type:Individual
Prefix:MS
First Name:KATIE
Middle Name:B
Last Name:HOPONICK
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5516 ADAMSTOWN COMMONS DR
Mailing Address - Street 2:
Mailing Address - City:ADAMSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21710-8918
Mailing Address - Country:US
Mailing Address - Phone:301-518-6492
Mailing Address - Fax:
Practice Address - Street 1:5516 ADAMSTOWN COMMONS DRIVE
Practice Address - Street 2:
Practice Address - City:ADAMSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21710
Practice Address - Country:US
Practice Address - Phone:301-518-6492
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2017-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA3042225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDA3042Medicare PIN