Provider Demographics
NPI:1285842047
Name:SOPHIA ASLANIS RD, CDN, LLC
Entity type:Organization
Organization Name:SOPHIA ASLANIS RD, CDN, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:MS
Authorized Official - First Name:SOPHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ASLANIS
Authorized Official - Suffix:
Authorized Official - Credentials:RD,CDN
Authorized Official - Phone:212-245-0575
Mailing Address - Street 1:250 W 57TH ST STE 1513
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10107-1509
Mailing Address - Country:US
Mailing Address - Phone:212-245-0575
Mailing Address - Fax:212-245-6131
Practice Address - Street 1:250 W 57TH ST STE 1513
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10107-1509
Practice Address - Country:US
Practice Address - Phone:212-245-0575
Practice Address - Fax:212-245-6131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005526-1133NN1002X, 133V00000X, 133VN1004X, 133VN1006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, EducationGroup - Single Specialty
No133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
No133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, PediatricGroup - Single Specialty
No133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, MetabolicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP2959660OtherOXFORD
NY7159555OtherAETNA
NY9245E1OtherEMPIREBLUECROSSBLUESHIELD
NY9245E1OtherBLUE CROSS BLUE SHIELD
NY6300090OtherUNITED HEALTHCARE
NY8890849OtherCIGNA
NY9245EOtherEMPIREBLUECROSSBLUESHIELD
NY149491POtherHIP
NY8099819OtherGHI
NY8099819OtherGHI
NY9245E1OtherEMPIREBLUECROSSBLUESHIELD