Basic Information
| Provider Information | |||||||||
| NPI: | 1326452491 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KAY | ||||||||
| FirstName: | SOPHIE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | M.A., ED.M | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2367-69 SECOND AVE | ||||||||
| Address2: | HARLEM EAST LIFE PLAN | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10035 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2128762300 | ||||||||
| FaxNumber: | 9174929202 | ||||||||
| Practice Location | |||||||||
| Address1: | 103 W BROAD ST | ||||||||
| Address2: | |||||||||
| City: | STAMFORD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 069023713 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2033246127 | ||||||||
| FaxNumber: | 2033489378 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/17/2014 | ||||||||
| LastUpdateDate: | 08/05/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 102L00000X | N | Behavioral Health & Social Service Providers | Psychoanalyst | 106H00000X | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.