Provider Demographics
NPI:1447217617
Name:SOFER, DAVID (PT)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:
Last Name:SOFER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:89 4TH PL
Mailing Address - Street 2:BSMT APT
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11231-4027
Mailing Address - Country:US
Mailing Address - Phone:718-522-3912
Mailing Address - Fax:718-421-5391
Practice Address - Street 1:1818 NEWKIRK AVE
Practice Address - Street 2:LOBBY D
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-7359
Practice Address - Country:US
Practice Address - Phone:718-859-2626
Practice Address - Fax:718-421-5391
Is Sole Proprietor?:No
Enumeration Date:2006-04-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY021509225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY152539POtherHIP
NYA3242137OtherOXFORD
NY152539POtherHIP