Individual
ADDISON SOPHIA DAUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
485 MADISON AVE FL 8, NEW YORK, NY 10022-5803
(646) 480-2821
Mailing address
485 MADISON AVE FL 8, NEW YORK, NY 10022-5803
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
030632
NY
Other
Enumeration date
07/19/2023
Last updated
11/13/2024
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