Provider Demographics
NPI:1609032390
Name:SOFER, ORLY (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ORLY
Middle Name:
Last Name:SOFER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1735 YORK AVE
Mailing Address - Street 2:APT 24B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-6855
Mailing Address - Country:US
Mailing Address - Phone:917-734-0386
Mailing Address - Fax:
Practice Address - Street 1:333 E 34TH ST
Practice Address - Street 2:SUITE 1-O
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-4977
Practice Address - Country:US
Practice Address - Phone:917-734-0386
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-01
Last Update Date:2008-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016557-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical