Provider Demographics
NPI:1164758637
Name:TRUJILLO-ARCIERI, SOFIA (SLP)
Entity Type:Individual
Prefix:
First Name:SOFIA
Middle Name:
Last Name:TRUJILLO-ARCIERI
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:552 CROSS ST
Mailing Address - Street 2:
Mailing Address - City:TOWNSHIP OF WASHINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07676-4326
Mailing Address - Country:US
Mailing Address - Phone:201-497-5067
Mailing Address - Fax:
Practice Address - Street 1:554 FORT WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033-2003
Practice Address - Country:US
Practice Address - Phone:212-740-5157
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-19
Last Update Date:2009-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017959-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist