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General NPI Number Information
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NPI Number | 1962386300
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Entity Type | Organization
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Legal Business Name | SOFIA S MOBILE PRIMARY CARE LLC
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Dates
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Enumeration Date | 07/31/2025
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Last Update Date | 07/31/2025
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Provider Practice Location Address
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Address Line | 18 N 2ND AVE
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City | HIGHLAND PARK
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State | NJ
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Zip | 08904-2419
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Country | US
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Telephone | 908-331-2518
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Fax |
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Provider Business Mailing Address
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Address Line | 18 N 2ND AVE
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City | HIGHLAND PARK
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State | NJ
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Zip | 08904-2419
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Country | US
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Telephone | 908-331-2518
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SOFIA SHECK EYAKEM
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Credential |
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Telephone | 908-331-2518
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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