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General NPI Number Information
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NPI Number | 1932972866
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Entity Type | Individual
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Provider Name | ELIZABETH SOPIRA PA-C
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Gender | Female
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Dates
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Enumeration Date | 11/02/2023
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Last Update Date | 03/26/2024
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Provider Practice Location Address
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Address Line | 120 E 65TH ST
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City | NEW YORK
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State | NY
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Zip | 10065-7072
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Country | US
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Telephone | 201-552-4645
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Fax |
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Provider Business Mailing Address
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Address Line | 52 7TH AVE APT 4F
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City | BROOKLYN
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State | NY
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Zip | 11217-3615
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Country | US
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Telephone | 650-468-9844
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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 | 030577
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License Number State | NY
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