Healthcare Provider Details

I. General information

NPI: 1275267346
Provider Name (Legal Business Name): SOPHIA CHIARAMONTE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2022
Last Update Date: 07/13/2022
Certification Date: 07/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1510 WATERS PL
BRONX NY
10461-2700
US

IV. Provider business mailing address

1510 WATERS PL
BRONX NY
10461-2700
US

V. Phone/Fax

Practice location:
  • Phone: 718-409-9433
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number116793
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: