Provider Demographics
NPI:1417291790
Name:SONATA ENDOCRINOLOGY
Entity Type:Organization
Organization Name:SONATA ENDOCRINOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:V
Authorized Official - Last Name:MAYRIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:267-242-0028
Mailing Address - Street 1:1197 SOMERS RD
Mailing Address - Street 2:
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006-1923
Mailing Address - Country:US
Mailing Address - Phone:267-242-0028
Mailing Address - Fax:
Practice Address - Street 1:1197 SOMERS RD
Practice Address - Street 2:
Practice Address - City:HUNTINGDON VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19006-1923
Practice Address - Country:US
Practice Address - Phone:267-242-0028
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-26
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty