Provider Demographics
NPI:1629021548
Name:SONI, DHIREN (DO)
Entity Type:Individual
Prefix:
First Name:DHIREN
Middle Name:
Last Name:SONI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 FEDERAL ST
Mailing Address - Street 2:STE SW200
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-1155
Mailing Address - Country:US
Mailing Address - Phone:856-356-4924
Mailing Address - Fax:856-356-4710
Practice Address - Street 1:1 COOPER PLZ
Practice Address - Street 2:COOPER ANESTHESIA ASSOCIATES
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08103-1461
Practice Address - Country:US
Practice Address - Phone:856-342-2425
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2018-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB076149207LP2900X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ00107776800OtherAMERICHOICE
NJ2459044000OtherAMERIHEALTH/KEYSTONE/IBC
NJAETNAOther1253156
NJ1866684OtherCIGNA
NJ1175455OtherHORIZON NJ HEALTH
NJ60024644OtherHORIZON NJ HEALTH
NJ0028681Medicaid
NJ1987629OtherUNITED HEALTHCARE
NJP3722604OtherOXFORD
NJP3722604OtherOXFORD
NJ2459044000OtherAMERIHEALTH/KEYSTONE/IBC