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NPI Code Detail

MEDICARE: ELIZABETH A. SOFIA P.A.

MEDICARE: ELIZABETH A. SOFIA P.A.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant6166GA

General Provider Information

NPI Number : 1194836197
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH A. SOFIA P.A.
Provider Business Mailing Address
First Line : 1425 PORTLAND AVE
Second Line :
City : ROCHESTER
State : NY
Zip : 14621-3001
Country : US
Telephone Number : 585-922-4000
Fax Number :
Provider Business Practice Location Address
First Line : 21 ORTHO LN
Second Line :
City : ATLANTA
State : GA
Zip : 30329-2315
Country : US
Telephone Number : 404-778-3350
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2006
Last Update Date : 10/04/2021

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