Provider Demographics
NPI:1497047674
Name:SOKOLOV, CHARLOTTE (DPT)
Entity Type:Individual
Prefix:DR
First Name:CHARLOTTE
Middle Name:
Last Name:SOKOLOV
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:CHARLOTTE
Other - Middle Name:
Other - Last Name:LESCHINSKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:27 CROFT PL
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-6501
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:39 SHERRI LN
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10977-1309
Practice Address - Country:US
Practice Address - Phone:845-520-1488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-06
Last Update Date:2017-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031507261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy