Provider Demographics
NPI:1477592897
Name:SONSINO, MICHELE LEE (OD)
Entity Type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:LEE
Last Name:SONSINO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2817 W END AVE
Mailing Address - Street 2:SUITE 107
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1453
Mailing Address - Country:US
Mailing Address - Phone:615-321-4393
Mailing Address - Fax:615-321-4393
Practice Address - Street 1:2817 W END AVE
Practice Address - Street 2:SUITE 107
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1453
Practice Address - Country:US
Practice Address - Phone:615-321-4393
Practice Address - Fax:615-321-4393
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-05
Last Update Date:2014-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNOD 2487152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN205162OtherEYEMED INSURANCE/AETNA
TN203257844OtherVSP INSURANCE
TN4115319OtherBLUE CROSS BLUE SHIELD TN
TN4115319OtherBLUE CROSS BLUE SHIELD TN
TN205162OtherEYEMED INSURANCE/AETNA
TN4115319OtherBLUE CROSS BLUE SHIELD TN