Individual
SOPHIE REN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
323 E MIDDLE COUNTRY RD STE 3, SMITHTOWN, NY 11787-2822
(631) 780-5511
Mailing address
323 E MIDDLE COUNTRY RD STE 3, SMITHTOWN, NY 11787-2822
(631) 780-5511
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
006855
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
006855
171100000X
NY
01
—
1234622
171100000X
NY
Enumeration date
02/15/2021
Last updated
02/15/2021
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