Provider Demographics
NPI:1780830927
Name:FORDE, SONIA CAROLYN/ANNETTE (LPN)
Entity Type:Individual
Prefix:MS
First Name:SONIA
Middle Name:CAROLYN/ANNETTE
Last Name:FORDE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 WILLIAMS ST
Mailing Address - Street 2:APT 14 C
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-8024
Mailing Address - Country:US
Mailing Address - Phone:845-486-5022
Mailing Address - Fax:845-473-5900
Practice Address - Street 1:14 WILLIAMS ST
Practice Address - Street 2:APT 14 C
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-8024
Practice Address - Country:US
Practice Address - Phone:845-486-5022
Practice Address - Fax:845-473-5900
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-07
Last Update Date:2008-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY252629-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse