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General NPI Number Information
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NPI Number | 1336212166
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Entity Type | Organization
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Legal Business Name | SOHO OBSTETRICS & GYNECOLOGY PC
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Dates
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Enumeration Date | 11/17/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 430 WEST BROADWAY 2A
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City | NEW YORK
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State | NY
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Zip | 10012
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Country | US
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Telephone | 212-941-0011
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Fax | 212-941-5977
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Provider Business Mailing Address
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Address Line | 430 WEST BROADWAY SUITE 2A
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City | NEW YORK
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State | NY
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Zip | 10012
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Country | US
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Telephone | 212-941-0011
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Fax | 212-941-5977
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | DEBORAH COADY
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Credential | MD
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Telephone | 212-941-0011
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number |
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License Number State |
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