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General NPI Number Information
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NPI Number | 1639772791
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Entity Type | Individual
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Provider Name | SOPHIA AIZIN PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 11/19/2020
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Last Update Date | 07/18/2023
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Provider Practice Location Address
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Address Line | 70 W 95TH ST APT 14D
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City | NEW YORK
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State | NY
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Zip | 10025-6725
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Country | US
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Telephone | 929-255-4693
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Fax |
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Provider Business Mailing Address
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Address Line | 408 MAMARONECK AVE FL 2
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City | MAMARONECK
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State | NY
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Zip | 10543-2613
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Country | US
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Telephone | 929-255-4693
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 023857
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License Number State | NY
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