Individual
SOPHIA BLEARY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1222 BERGEN AVE, BROOKLYN, NY 11234-5677
(929) 498-3159
Mailing address
1222 BERGEN AVE, BROOKLYN, NY 11234-5677
(929) 498-3159
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
236
—
NY
Enumeration date
03/03/2023
Last updated
03/03/2023
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