Provider Demographics
NPI:1457028540
Name:SEROBIAN, SOPHIA (OD)
Entity Type:Individual
Prefix:DR
First Name:SOPHIA
Middle Name:
Last Name:SEROBIAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 LITTLE WEST ST APT 7D
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10004-7432
Mailing Address - Country:US
Mailing Address - Phone:212-785-0797
Mailing Address - Fax:
Practice Address - Street 1:70 LITTLE WEST ST APT 7D
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10004-7432
Practice Address - Country:US
Practice Address - Phone:917-626-5528
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-25
Last Update Date:2022-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009409152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist