Provider Demographics
NPI:1184036881
Name:JOHN, SONIA R (SPECIAL ED TEACHER)
Entity Type:Individual
Prefix:MS
First Name:SONIA
Middle Name:R
Last Name:JOHN
Suffix:
Gender:F
Credentials:SPECIAL ED TEACHER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:226 E 53RD ST APT 2R
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-3651
Mailing Address - Country:US
Mailing Address - Phone:917-583-0552
Mailing Address - Fax:
Practice Address - Street 1:226 E 53RD ST APT 2R
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-3651
Practice Address - Country:US
Practice Address - Phone:917-583-0552
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-29
Last Update Date:2014-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist