Provider Demographics
NPI:1780644690
Name:SONI, SUSAN K (MD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:K
Last Name:SONI
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1202 TROY SCHENECTADY RD
Mailing Address - Street 2:BUILDING #2
Mailing Address - City:LATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12110-1095
Mailing Address - Country:US
Mailing Address - Phone:518-220-9393
Mailing Address - Fax:518-220-9123
Practice Address - Street 1:1202 TROY SCHENECTADY RD
Practice Address - Street 2:BUILDING #2
Practice Address - City:LATHAM
Practice Address - State:NY
Practice Address - Zip Code:12110-1095
Practice Address - Country:US
Practice Address - Phone:518-220-9393
Practice Address - Fax:518-220-9123
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-24
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
NY119401207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00529608Medicaid
NY00529608Medicaid
NYC59072Medicare UPIN