Provider Demographics
NPI:1871395780
Name:SOFRONOVA, ELIZAVETA (RN)
Entity type:Individual
Prefix:MRS
First Name:ELIZAVETA
Middle Name:
Last Name:SOFRONOVA
Suffix:
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:272 93RD ST # 2
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-6806
Mailing Address - Country:US
Mailing Address - Phone:305-283-9727
Mailing Address - Fax:
Practice Address - Street 1:272 93RD ST # 2
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-6806
Practice Address - Country:US
Practice Address - Phone:305-283-9727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-24
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY906500163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse