Provider Demographics
NPI:1457366924
Name:SOFKA, CAROLYN M (MD)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:M
Last Name:SOFKA
Suffix:
Gender:F
Credentials:MD
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Other - Last Name:
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Mailing Address - Street 1:535 E 70TH ST
Mailing Address - Street 2:HOSPITAL FOR SPECIAL SURGERY - RADIOLOGY
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4872
Mailing Address - Country:US
Mailing Address - Phone:212-606-1130
Mailing Address - Fax:212-734-7378
Practice Address - Street 1:535 E 70TH ST
Practice Address - Street 2:HOSPITAL FOR SPECIAL SURGERY - RADIOLOGY
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4872
Practice Address - Country:US
Practice Address - Phone:212-606-1130
Practice Address - Fax:212-734-7378
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY2128082085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00637403Medicaid
NY02078751Medicaid
NY00637403Medicaid
NYCS00C05510Medicare ID - Type Unspecified
NY02078751Medicaid