Provider Demographics
NPI:1215741160
Name:KASS, SOPHIA (PT, DPT)
Entity type:Individual
Prefix:
First Name:SOPHIA
Middle Name:
Last Name:KASS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1331 E VICTOR RD
Mailing Address - Street 2:
Mailing Address - City:VICTOR
Mailing Address - State:NY
Mailing Address - Zip Code:14564-9306
Mailing Address - Country:US
Mailing Address - Phone:585-742-8270
Mailing Address - Fax:585-742-8272
Practice Address - Street 1:1331 E VICTOR RD
Practice Address - Street 2:
Practice Address - City:VICTOR
Practice Address - State:NY
Practice Address - Zip Code:14564-9306
Practice Address - Country:US
Practice Address - Phone:585-742-8270
Practice Address - Fax:585-742-8272
Is Sole Proprietor?:No
Enumeration Date:2025-02-03
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY053687225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist