Provider Demographics
NPI:1598143448
Name:PATEL, SONIA
Entity Type:Individual
Prefix:
First Name:SONIA
Middle Name:
Last Name:PATEL
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 1:205 BURLINGTON RD
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01730-1406
Mailing Address - Country:US
Mailing Address - Phone:781-761-5165
Mailing Address - Fax:781-275-7207
Practice Address - Street 1:205 BURLINGTON RD
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:01730
Practice Address - Country:US
Practice Address - Phone:781-761-5165
Practice Address - Fax:781-275-7207
Is Sole Proprietor?:No
Enumeration Date:2015-05-12
Last Update Date:2018-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0000023532OtherBMC
MAM18633OtherBCBS
MA042611055OtherTAX ID
MA1004745OtherNHP
MA1303287OtherMBHP
MA99618201OtherNETWORK HEALTH
MA1004745OtherFALLON