Provider Demographics
NPI:1093076911
Name:DEFREITAS, SONIA (MSSPED)
Entity Type:Individual
Prefix:MS
First Name:SONIA
Middle Name:
Last Name:DEFREITAS
Suffix:
Gender:F
Credentials:MSSPED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11855 222ND ST
Mailing Address - Street 2:
Mailing Address - City:CAMBRIA HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11411-2016
Mailing Address - Country:US
Mailing Address - Phone:347-248-4679
Mailing Address - Fax:
Practice Address - Street 1:11855 222ND ST
Practice Address - Street 2:
Practice Address - City:CAMBRIA HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11411-2016
Practice Address - Country:US
Practice Address - Phone:347-248-4679
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-06
Last Update Date:2012-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist