Provider Demographics
NPI:1578065124
Name:ARUTUNIAN, SOFIA (RN)
Entity Type:Individual
Prefix:
First Name:SOFIA
Middle Name:
Last Name:ARUTUNIAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:375 DICK RD STE 3
Mailing Address - Street 2:
Mailing Address - City:DEPEW
Mailing Address - State:NY
Mailing Address - Zip Code:14043-1816
Mailing Address - Country:US
Mailing Address - Phone:716-602-5750
Mailing Address - Fax:
Practice Address - Street 1:1775 WEHRLE DR STE 150
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-7025
Practice Address - Country:US
Practice Address - Phone:716-025-7506
Practice Address - Fax:716-391-1926
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-28
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY566706163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health