Healthcare Provider Details

I. General information

NPI: 1629843867
Provider Name (Legal Business Name): SOPHIA BELCHIOR CUNHA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SOPHIA B COSTA NP

II. Dates (important events)

Enumeration Date: 11/17/2023
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

363 HIGHLAND AVE
FALL RIVER MA
02720-3703
US

IV. Provider business mailing address

11 DEERFIELD DR
BERKLEY MA
02779-1031
US

V. Phone/Fax

Practice location:
  • Phone: 508-679-3131
  • Fax:
Mailing address:
  • Phone: 774-406-9055
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: