Provider Demographics
NPI:1003205774
Name:PEREZ, SONYA ANTOINETTE (RN)
Entity Type:Individual
Prefix:MRS
First Name:SONYA
Middle Name:ANTOINETTE
Last Name:PEREZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 OAK DR
Mailing Address - Street 2:
Mailing Address - City:RONKONKOMA
Mailing Address - State:NY
Mailing Address - Zip Code:11779-3190
Mailing Address - Country:US
Mailing Address - Phone:631-648-4948
Mailing Address - Fax:
Practice Address - Street 1:27 OAK DR
Practice Address - Street 2:
Practice Address - City:RONKONKOMA
Practice Address - State:NY
Practice Address - Zip Code:11779-3190
Practice Address - Country:US
Practice Address - Phone:631-648-4948
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-17
Last Update Date:2015-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY689325163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse