Provider Demographics
NPI:1245447010
Name:VASSOS, SONYA (PHD)
Entity type:Individual
Prefix:
First Name:SONYA
Middle Name:
Last Name:VASSOS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 5TH AVE PH N
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-8842
Mailing Address - Country:US
Mailing Address - Phone:212-995-9592
Mailing Address - Fax:212-995-9592
Practice Address - Street 1:412 AVENUE OF THE AMERICAS
Practice Address - Street 2:SUITE 705
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-8409
Practice Address - Country:US
Practice Address - Phone:212-995-9592
Practice Address - Fax:212-995-9592
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2013-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002437101YM0800X
VT098-0000197102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst