Provider Demographics
NPI:1104412451
Name:ADAMS, SOFIA (OTR/L)
Entity type:Individual
Prefix:
First Name:SOFIA
Middle Name:
Last Name:ADAMS
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:SOFIA
Other - Middle Name:
Other - Last Name:GIZZIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 411422
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-1422
Mailing Address - Country:US
Mailing Address - Phone:914-294-4050
Mailing Address - Fax:
Practice Address - Street 1:630 CHURCHMANS RD STE 100A
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-1943
Practice Address - Country:US
Practice Address - Phone:302-544-5055
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-20
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC017222225X00000X
DEU1-0012217225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist