Provider Demographics
NPI:1336468149
Name:VANDANA SONI PHYSICIAN PC
Entity Type:Organization
Organization Name:VANDANA SONI PHYSICIAN PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VANDAN
Authorized Official - Middle Name:K
Authorized Official - Last Name:SONI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-932-8876
Mailing Address - Street 1:700 OLD COUNTRY RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-4932
Mailing Address - Country:US
Mailing Address - Phone:516-932-8876
Mailing Address - Fax:516-822-3637
Practice Address - Street 1:700 OLD COUNTRY RD
Practice Address - Street 2:SUITE 205
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-4932
Practice Address - Country:US
Practice Address - Phone:516-932-8876
Practice Address - Fax:516-822-3637
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-19
Last Update Date:2010-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1959282084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG05020Medicare UPIN