Provider Demographics
NPI:1346406600
Name:SIMOES, SONIA C (MD)
Entity Type:Individual
Prefix:DR
First Name:SONIA
Middle Name:C
Last Name:SIMOES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:390 NEW YORK AVE
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07105-3125
Mailing Address - Country:US
Mailing Address - Phone:973-755-1585
Mailing Address - Fax:201-839-3312
Practice Address - Street 1:390 NEW YORK AVE
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07105-3125
Practice Address - Country:US
Practice Address - Phone:973-755-1585
Practice Address - Fax:201-839-3312
Is Sole Proprietor?:No
Enumeration Date:2008-08-05
Last Update Date:2016-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08341200207R00000X, 207RN0300X
VA0101245915207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine