Provider Demographics
NPI:1407911357
Name:SONI, PARAG
Entity Type:Individual
Prefix:MR
First Name:PARAG
Middle Name:
Last Name:SONI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 BERNICE ST
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-1727
Mailing Address - Country:US
Mailing Address - Phone:732-910-7301
Mailing Address - Fax:
Practice Address - Street 1:108 BROADWAY
Practice Address - Street 2:
Practice Address - City:PASSAIC
Practice Address - State:NJ
Practice Address - Zip Code:07055-3903
Practice Address - Country:US
Practice Address - Phone:973-916-1111
Practice Address - Fax:973-916-1113
Is Sole Proprietor?:No
Enumeration Date:2006-12-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02726900183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist