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NPI Code Detail

MEDICARE: SOFIA DISANTI LCSW PLLC

MEDICARE: SOFIA DISANTI LCSW PLLC
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
11041C0700XClinical Social Worker083424NY

General Provider Information

NPI Number : 1760988158
Entity Type Code : Organization
Provider Name (Legal Business Name) : SOFIA DISANTI LCSW PLLC
Provider Business Mailing Address
First Line : 315 MADISON AVE RM 506
Second Line :
City : NEW YORK
State : NY
Zip : 10017-5436
Country : US
Telephone Number : 347-670-4479
Fax Number :
Provider Business Practice Location Address
First Line : 315 MADISON AVE
Second Line : RM 506
City : NEW YORK
State : NY
Zip : 10017-5436
Country : US
Telephone Number : 347-670-4479
Fax Number :
Authorized Official
Title or Position : OWNER
Name : SOFIA FRANK
Credential : LCSW-R
Telephone Number : 347-670-4479
Provider Enumeration Date : 04/04/2018
Last Update Date : 09/01/2021

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