Provider Demographics
NPI:1548401334
Name:SOHNGEN, DANIELLE MARIA
Entity Type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:MARIA
Last Name:SOHNGEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 GARDEN CT
Mailing Address - Street 2:PORT JEFFERSON STATION
Mailing Address - City:PORT JEFFERSON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11776-2919
Mailing Address - Country:US
Mailing Address - Phone:631-764-7972
Mailing Address - Fax:
Practice Address - Street 1:6 GARDEN CT
Practice Address - Street 2:PORT JEFFERSON STATION
Practice Address - City:PORT JEFFERSON STATION
Practice Address - State:NY
Practice Address - Zip Code:11776-2919
Practice Address - Country:US
Practice Address - Phone:631-764-7972
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-09
Last Update Date:2009-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1937639174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist