Provider Demographics
NPI:1942523592
Name:SOFRONIS, EVANGELIA (RPA)
Entity Type:Individual
Prefix:
First Name:EVANGELIA
Middle Name:
Last Name:SOFRONIS
Suffix:
Gender:F
Credentials:RPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20014 44TH AVE
Mailing Address - Street 2:
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11361-2510
Mailing Address - Country:US
Mailing Address - Phone:917-567-5926
Mailing Address - Fax:
Practice Address - Street 1:20014 44TH AVE
Practice Address - Street 2:
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11361-2510
Practice Address - Country:US
Practice Address - Phone:917-567-5926
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-10
Last Update Date:2010-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP74714363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical