1396090494 NPI number — MS. SOFIJA SONJA GALIC M.A. BCBA CBA

Table of content: MS. SOFIJA SONJA GALIC M.A. BCBA CBA (NPI 1396090494)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396090494 NPI number — MS. SOFIJA SONJA GALIC M.A. BCBA CBA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GALIC
Provider First Name:
SOFIJA
Provider Middle Name:
SONJA
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
M.A. BCBA CBA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1396090494
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/29/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
151 1ST AVE APT
Provider Second Line Business Mailing Address:
APT 117
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10003
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
917-583-3730
Provider Business Mailing Address Fax Number:
518-777-3293

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
120 BENCHELY PLACE
Provider Second Line Business Practice Location Address:
FRONT 2
Provider Business Practice Location Address City Name:
BRONX
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10475-3402
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
347-843-7760
Provider Business Practice Location Address Fax Number:
347-843-7780
Provider Enumeration Date:
07/16/2012

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: 174400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103K00000X , with the licence number: 002067-01 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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