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NPI Code Detail

MEDICARE: SOPHONIE AMESFORT

MEDICARE: SOPHONIE AMESFORT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse819498NY

General Provider Information

NPI Number : 1659046019
Entity Type Code : Individual
Provider Name (Legal Business Name) : SOPHONIE AMESFORT
Provider Business Mailing Address
First Line : 149 E 31ST ST APT G2
Second Line :
City : BROOKLYN
State : NY
Zip : 11226-5142
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1312 CATON AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11226-1002
Country : US
Telephone Number : 718-693-7000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2021
Last Update Date : 08/09/2021

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Directions to “ SOPHONIE AMESFORT ” Practice Location

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