Provider Demographics
NPI:1679670053
Name:URBANYI, SOPHIA EVA
Entity Type:Individual
Prefix:
First Name:SOPHIA
Middle Name:EVA
Last Name:URBANYI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:VA MEDICAL CENTER
Mailing Address - Street 2:4801 VETERANS DRIVE
Mailing Address - City:ST.CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-2099
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:VA MEDICAL CENTER
Practice Address - Street 2:4801 VETERANS DRIVE
Practice Address - City:ST.CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303-2099
Practice Address - Country:US
Practice Address - Phone:320-255-6465
Practice Address - Fax:320-255-6360
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN115705-9183500000X
NE10419183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist