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General NPI Number Information
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NPI Number | 1497184568
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Entity Type | Organization
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Legal Business Name | SOHO MEDICAL DOCTORS, PLLC
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Dates
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Enumeration Date | 11/08/2013
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Last Update Date | 10/27/2023
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Provider Practice Location Address
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Address Line | 104 W 40TH ST RM 500
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City | NEW YORK
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State | NY
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Zip | 10018-3770
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Country | US
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Telephone | 212-369-6757
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Fax | 212-369-3941
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Provider Business Mailing Address
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Address Line | 104 W 40TH ST RM 500
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City | NEW YORK
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State | NY
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Zip | 10018-3770
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Country | US
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Telephone | 212-369-6757
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Fax | 212-369-3941
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Authorized Official
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Title or Position | PSYCHIATRIST
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Name | DR. JACQUES JOSPITRE JR.
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Credential | M.D.
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Telephone | 212-369-6757
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 228171
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License Number State | NY
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