Provider Demographics
NPI:1205518370
Name:MASSAQUOI, SOPHIE JARTU (MD)
Entity type:Individual
Prefix:MS
First Name:SOPHIE
Middle Name:JARTU
Last Name:MASSAQUOI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2402 DEEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229-2255
Mailing Address - Country:US
Mailing Address - Phone:614-966-6166
Mailing Address - Fax:
Practice Address - Street 1:2402 DEEWOOD DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-2255
Practice Address - Country:US
Practice Address - Phone:614-966-6166
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-07
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No374U00000XNursing Service Related ProvidersHome Health Aide
No251G00000XAgenciesHospice Care, Community Based