Provider Demographics
NPI:1093495558
Name:JENZA, SOFIJA (OD)
Entity Type:Individual
Prefix:DR
First Name:SOFIJA
Middle Name:
Last Name:JENZA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:LIZA
Other - Middle Name:
Other - Last Name:JENZA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:413 E GEORGE ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19125-4215
Mailing Address - Country:US
Mailing Address - Phone:267-566-4501
Mailing Address - Fax:
Practice Address - Street 1:2000 NJ-38
Practice Address - Street 2:SUITE 1735
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08002
Practice Address - Country:US
Practice Address - Phone:646-798-6230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-20
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00721000152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist