Individual
NICOLE M SOPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
38 ROUTE 134, SOUTH DENNIS, MA 02660-3700
(150) 839-4221
(508) 398-4471
Mailing address
PO BOX 1412, SOUTH DENNIS, MA 02660-1412
(150) 839-4221
(508) 398-4471
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5024
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AA67522326
MEDICARE PTAN
SC
05
—
D16089
—
SC
01
—
S400176567
MEDICARE PTAN
MA
Enumeration date
09/14/2010
Last updated
08/11/2015
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