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SOPHY DEDOPOULOS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
410 LAKEVILLE RD, SUITE 107, NEW HYDE PARK, NY 11042-1101
(516) 465-5400
(516) 465-5454
Mailing address
972 BRUSH HOLLOW RD, 4TH FLOOR, WESTBURY, NY 11590-1740
(516) 876-5555
(516) 876-5539

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
497423 / 303779
NY
363LP2300X
Primary Care Nurse Practitioner
Primary
303779
NY

Other

Enumeration date
08/20/2006
Last updated
02/16/2017
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