Provider Demographics
NPI:1073885463
Name:SOFFLER, RHONDA
Entity Type:Individual
Prefix:MS
First Name:RHONDA
Middle Name:
Last Name:SOFFLER
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:RHONDA
Other - Middle Name:
Other - Last Name:SOFFLER KAHGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13831 JEWEL AVE
Mailing Address - Street 2:APT 1A
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-1902
Mailing Address - Country:US
Mailing Address - Phone:718-662-8066
Mailing Address - Fax:
Practice Address - Street 1:13831 JEWEL AVE
Practice Address - Street 2:APT 1A
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11367-1902
Practice Address - Country:US
Practice Address - Phone:718-662-8066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-01
Last Update Date:2014-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY144167174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist