Provider Demographics
NPI:1043473309
Name:HOENIG, SANDRA (MD,)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:
Last Name:HOENIG
Suffix:
Gender:F
Credentials:MD,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 CHANGEBRIDGE RD
Mailing Address - Street 2:SUITE C3
Mailing Address - City:MONTVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07045-9115
Mailing Address - Country:US
Mailing Address - Phone:973-575-5540
Mailing Address - Fax:973-575-4885
Practice Address - Street 1:170 CHANGEBRIDGE RD
Practice Address - Street 2:SUITE C3
Practice Address - City:MONTVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07045-9115
Practice Address - Country:US
Practice Address - Phone:973-575-5540
Practice Address - Fax:973-575-4885
Is Sole Proprietor?:No
Enumeration Date:2008-07-08
Last Update Date:2013-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08832700207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ231870B3CMedicare UPIN