Provider Demographics
NPI:1306230909
Name:BOHACZUK, SONYA (MD, MPH)
Entity Type:Individual
Prefix:
First Name:SONYA
Middle Name:
Last Name:BOHACZUK
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 WESTCHESTER AVE STE S620
Mailing Address - Street 2:
Mailing Address - City:RYE BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:10573-1328
Mailing Address - Country:US
Mailing Address - Phone:914-428-5454
Mailing Address - Fax:
Practice Address - Street 1:41 E POST RD
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601-4607
Practice Address - Country:US
Practice Address - Phone:914-681-0600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-23
Last Update Date:2020-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY297560207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology