=====================================================
General NPI Number Information
=====================================================
NPI Number | 1912844259
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SOPHIA LEE FOGLIA
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/04/2026
-----------------------------------------------------
Last Update Date | 05/04/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 300 PANTIGO PL STE 115
-----------------------------------------------------
City | EAST HAMPTON
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11937-5907
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 631-760-7442
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 1297
-----------------------------------------------------
City | MONTAUK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11954-0896
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 631-599-8092
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225700000X
-----------------------------------------------------
Taxonomy Name | Massage Therapist
-----------------------------------------------------
License Number | 033697-01
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------