Provider Demographics
NPI:1285425132
Name:KUPRADZE, SOPIO
Entity type:Individual
Prefix:
First Name:SOPIO
Middle Name:
Last Name:KUPRADZE
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 1:155 BORDEN AVE APT 11R
Mailing Address - Street 2:
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11101-6230
Mailing Address - Country:US
Mailing Address - Phone:347-610-3550
Mailing Address - Fax:
Practice Address - Street 1:155 BORDEN AVE APT 11R
Practice Address - Street 2:
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11101-6230
Practice Address - Country:US
Practice Address - Phone:347-610-3550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-12
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171R00000XOther Service ProvidersInterpreterGroup - Single Specialty