Provider Demographics
NPI:1164727897
Name:PAPARO, SONNY B
Entity Type:Individual
Prefix:
First Name:SONNY
Middle Name:B
Last Name:PAPARO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:174 GRAND ST
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10601-4803
Mailing Address - Country:US
Mailing Address - Phone:914-328-8077
Mailing Address - Fax:914-328-6083
Practice Address - Street 1:741 E 233RD ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10466-3201
Practice Address - Country:US
Practice Address - Phone:718-405-0205
Practice Address - Fax:718-405-1628
Is Sole Proprietor?:No
Enumeration Date:2011-01-11
Last Update Date:2016-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY62030922174400000X
NY030922225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA400053114Medicare PIN
NYA400053261Medicare PIN
NYG400065624Medicare PIN
NYA400073233Medicare PIN
NYA400053206Medicare PIN
NYA400053427Medicare PIN
NYG400079601Medicare PIN