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Individual
SOPHIA JAN
Active
Individual
SOPHIA JAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D., M.S.H.P.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD290027
NY
207R00000X
Internal Medicine Physician
MD438300
PA
208000000X
Pediatrics Physician
Primary
MD290027
NY
Other
Enumeration date
05/22/2007
Last updated
09/25/2019
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