Provider Demographics
NPI:1275196057
Name:BISHNOI, SONALI LAXMI (DO)
Entity Type:Individual
Prefix:MISS
First Name:SONALI
Middle Name:LAXMI
Last Name:BISHNOI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:64 HIGHCREST RD
Mailing Address - Street 2:
Mailing Address - City:WETHERSFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06109-4031
Mailing Address - Country:US
Mailing Address - Phone:860-810-9575
Mailing Address - Fax:
Practice Address - Street 1:2015 PACIFIC AVE
Practice Address - Street 2:
Practice Address - City:ATLANTIC CITY
Practice Address - State:NJ
Practice Address - Zip Code:08401-6726
Practice Address - Country:US
Practice Address - Phone:609-449-4391
Practice Address - Fax:609-441-8907
Is Sole Proprietor?:No
Enumeration Date:2019-04-17
Last Update Date:2019-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program