1316193238 NPI number — MRS. LARA ELISABETH SOKOLOFF RD

Table of content: MRS. LARA ELISABETH SOKOLOFF RD (NPI 1316193238)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316193238 NPI number — MRS. LARA ELISABETH SOKOLOFF RD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SOKOLOFF
Provider First Name:
LARA
Provider Middle Name:
ELISABETH
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
RD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BROWN
Provider Other First Name:
LARA
Provider Other Middle Name:
ELISABETH
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
RD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1316193238
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/12/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2040 DEYERLE AVE
Provider Second Line Business Mailing Address:
SUITE 106
Provider Business Mailing Address City Name:
HARRISONBURG
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22801-3582
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
540-437-9575
Provider Business Mailing Address Fax Number:
540-437-9576

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2040 DEYERLE AVE
Provider Second Line Business Practice Location Address:
SUITE 106
Provider Business Practice Location Address City Name:
HARRISONBURG
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22801-3582
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
540-437-9575
Provider Business Practice Location Address Fax Number:
540-437-9576
Provider Enumeration Date:
08/12/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 133V00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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