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General NPI Number Information
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NPI Number | 1235929167
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Entity Type | Individual
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Provider Name | SOPHIA MIZRAHI
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Gender |
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Dates
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Enumeration Date | 05/12/2025
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Last Update Date | 05/12/2025
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Provider Practice Location Address
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Address Line | 214 SULLIVAN ST
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City | NEW YORK
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State | NY
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Zip | 10012-1354
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Country | US
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Telephone | 212-385-3700
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Fax |
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Provider Business Mailing Address
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Address Line | 1954 E 14TH ST
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City | BROOKLYN
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State | NY
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Zip | 11229-3312
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Country | US
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Telephone | 917-291-6407
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 033526
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License Number State | NY
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