Provider Demographics
NPI:1851818413
Name:SOLOFF, BROCHA
Entity Type:Individual
Prefix:MISS
First Name:BROCHA
Middle Name:
Last Name:SOLOFF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BROCHA
Other - Middle Name:
Other - Last Name:SOLOFF
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RD
Mailing Address - Street 1:1848 E 33RD ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-4426
Mailing Address - Country:US
Mailing Address - Phone:347-423-9668
Mailing Address - Fax:
Practice Address - Street 1:1848 E 33RD ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-4426
Practice Address - Country:US
Practice Address - Phone:347-423-9668
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-24
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009184133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered