Provider Demographics
NPI:1619548096
Name:SOCHA, KAROLINA (LMT)
Entity Type:Individual
Prefix:
First Name:KAROLINA
Middle Name:
Last Name:SOCHA
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2805 VETERANS MEMORIAL HWY STE 8
Mailing Address - Street 2:
Mailing Address - City:RONKONKOMA
Mailing Address - State:NY
Mailing Address - Zip Code:11779-7680
Mailing Address - Country:US
Mailing Address - Phone:631-738-8440
Mailing Address - Fax:
Practice Address - Street 1:4155 VETERANS MEMORIAL HWY STE 5
Practice Address - Street 2:
Practice Address - City:RONKONKOMA
Practice Address - State:NY
Practice Address - Zip Code:11779-6063
Practice Address - Country:US
Practice Address - Phone:631-412-4800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-07
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032612225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist