Provider Demographics
NPI:1083972095
Name:SONDEJ, JUSTYNA
Entity Type:Individual
Prefix:MRS
First Name:JUSTYNA
Middle Name:
Last Name:SONDEJ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6035 69TH PL
Mailing Address - Street 2:APT#1
Mailing Address - City:MASPETH
Mailing Address - State:NY
Mailing Address - Zip Code:11378-2928
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:33 S SERVICE RD
Practice Address - Street 2:ROOM 109
Practice Address - City:JERICHO
Practice Address - State:NY
Practice Address - Zip Code:11753-1036
Practice Address - Country:US
Practice Address - Phone:516-750-9760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-26
Last Update Date:2012-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005866-1225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant