Provider Demographics
NPI:1023390440
Name:SONE, SONGAH LISA (RPH)
Entity Type:Individual
Prefix:MRS
First Name:SONGAH
Middle Name:LISA
Last Name:SONE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 ANNE CT
Mailing Address - Street 2:
Mailing Address - City:NORWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07648-1254
Mailing Address - Country:US
Mailing Address - Phone:718-551-5557
Mailing Address - Fax:
Practice Address - Street 1:20 W HUDSON AVE
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-1788
Practice Address - Country:US
Practice Address - Phone:201-408-1374
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-12
Last Update Date:2011-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02451800183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist