Individual provider Active NPI

Sofia Pham, PHD

  • Psychologist
  • New York, NY
National Provider Identifier
1558830513
Registry record updated Nov 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
022920 Issued in NY
Practice address
954 Lexington Ave # 1038
New York, NY 10021-5055
Phone
(267) 266-9976
NPI assigned
Nov 20, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 022920 NY Primary

Addresses

Primary practice location

954 Lexington Ave # 1038
New York, NY 10021-5055

Mailing address

160 Riverside Blvd Apt 10V
New York, NY 10069-0708

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
022920NYMDOccupational Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1542672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542672000000",
    "number": "1558830513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 RIVERSIDE BLVD APT 10V",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100690708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "954 LEXINGTON AVE # 1038",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100215055",
            "telephone_number": "267-266-9976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "SOFIA",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-20",
        "last_updated": "2018-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "022920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.