Individual
SOPHIA RAHIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
204 FOLINO DR, BRIDGEPORT, CT 06606-1011
(508) 259-5843
Mailing address
204 FOLINO DR, BRIDGEPORT, CT 06606-1011
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MTN9800660571
BLUECROSS BLUESHIELD
MA
Enumeration date
01/18/2019
Last updated
01/18/2019
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