Provider Demographics
NPI:1538931951
Name:RAI, SOPHIN (NP)
Entity type:Individual
Prefix:
First Name:SOPHIN
Middle Name:
Last Name:RAI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5141 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10034-1159
Mailing Address - Country:US
Mailing Address - Phone:212-932-4000
Mailing Address - Fax:
Practice Address - Street 1:650 FROM RD STE 506
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-3517
Practice Address - Country:US
Practice Address - Phone:551-996-8100
Practice Address - Fax:551-996-4140
Is Sole Proprietor?:No
Enumeration Date:2023-10-30
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY351166363LF0000X
NJ26NJ15266600363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily