Provider Demographics
NPI:1366148199
Name:SAAD, SOPHIA (ATR-BC, LCAT)
Entity type:Individual
Prefix:
First Name:SOPHIA
Middle Name:
Last Name:SAAD
Suffix:
Gender:F
Credentials:ATR-BC, LCAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 E 57TH ST APT 11E
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-3009
Mailing Address - Country:US
Mailing Address - Phone:917-544-3749
Mailing Address - Fax:
Practice Address - Street 1:411 E 57TH ST APT 11E
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-3009
Practice Address - Country:US
Practice Address - Phone:917-544-3749
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-02
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001935221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist