Provider Demographics
NPI:1073490256
Name:DELUTRO, SOFIA
Entity type:Individual
Prefix:
First Name:SOFIA
Middle Name:
Last Name:DELUTRO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:182 DELMAR AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10312-2830
Mailing Address - Country:US
Mailing Address - Phone:718-300-1413
Mailing Address - Fax:
Practice Address - Street 1:2955 VETERANS RD W
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10309-2515
Practice Address - Country:US
Practice Address - Phone:347-896-5955
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-19
Last Update Date:2025-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist