Provider Demographics
NPI:1992757900
Name:ABBEY, ALKE SOPHIE (PT)
Entity type:Individual
Prefix:
First Name:ALKE
Middle Name:SOPHIE
Last Name:ABBEY
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 1:501 EXECUTIVE PL
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28305-5390
Mailing Address - Country:US
Mailing Address - Phone:910-423-5550
Mailing Address - Fax:910-423-5552
Practice Address - Street 1:501 EXECUTIVE PL
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28305-5390
Practice Address - Country:US
Practice Address - Phone:910-423-5550
Practice Address - Fax:910-423-5552
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2014-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9169225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC07PYGOtherBLUE CROSS BLUE SHIELD NC
NC125357800OtherTRICARE
NC125357800OtherUS DEPART OF LABOR
NC185562OtherMEDCOST
NC2508320Medicare ID - Type UnspecifiedMEDICARE PROVIDER #