Provider Demographics
NPI:1518665728
Name:BERMUDEZ, SONYA (RN)
Entity Type:Individual
Prefix:
First Name:SONYA
Middle Name:
Last Name:BERMUDEZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:69 HERKIMER ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14609-7019
Mailing Address - Country:US
Mailing Address - Phone:585-350-9823
Mailing Address - Fax:
Practice Address - Street 1:69 HERKIMER ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14609-7019
Practice Address - Country:US
Practice Address - Phone:585-350-9823
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-16
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY871430163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse