Provider Demographics
NPI:1043106818
Name:SIGNOR, SOPHIA (PA-C)
Entity type:Individual
Prefix:
First Name:SOPHIA
Middle Name:
Last Name:SIGNOR
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:SOPHIA
Other - Middle Name:LYNN-ISABEL
Other - Last Name:SIGNOR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:500 UNIVERSITY DR
Mailing Address - Street 2:MC CA410
Mailing Address - City:HERSHEY
Mailing Address - State:PA
Mailing Address - Zip Code:17033-2360
Mailing Address - Country:US
Mailing Address - Phone:800-243-1455
Mailing Address - Fax:717-531-0119
Practice Address - Street 1:500 UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:HERSHEY
Practice Address - State:PA
Practice Address - Zip Code:17033-2360
Practice Address - Country:US
Practice Address - Phone:717-531-8807
Practice Address - Fax:717-531-0132
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-17
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA066721363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant