Provider Demographics
NPI:1023186343
Name:CUBERO, SONIA IVETTE (PT)
Entity Type:Individual
Prefix:MS
First Name:SONIA
Middle Name:IVETTE
Last Name:CUBERO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 STONE HAVEN CT
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28146-3235
Mailing Address - Country:US
Mailing Address - Phone:704-279-7940
Mailing Address - Fax:
Practice Address - Street 1:1810 CONCORD LAKE RD
Practice Address - Street 2:
Practice Address - City:KANNAPOLIS
Practice Address - State:NC
Practice Address - Zip Code:28083-6434
Practice Address - Country:US
Practice Address - Phone:704-933-3781
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC53942251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5394OtherPHYSICAL THERAPY LICENSE