Provider Demographics
NPI:1780416743
Name:STRUZZIERO, SOPHIA KAY
Entity type:Individual
Prefix:
First Name:SOPHIA
Middle Name:KAY
Last Name:STRUZZIERO
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 1:321 DORCHESTER ST UNIT 1
Mailing Address - Street 2:
Mailing Address - City:SOUTH BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02127-2733
Mailing Address - Country:US
Mailing Address - Phone:617-833-1209
Mailing Address - Fax:
Practice Address - Street 1:321 DORCHESTER ST UNIT 1
Practice Address - Street 2:
Practice Address - City:SOUTH BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02127-2733
Practice Address - Country:US
Practice Address - Phone:617-833-1209
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-19
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program