Provider Demographics
NPI:1780867994
Name:GILBERT, SONYA (PA/C)
Entity Type:Individual
Prefix:MRS
First Name:SONYA
Middle Name:
Last Name:GILBERT
Suffix:
Gender:F
Credentials:PA/C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:GROVETON
Mailing Address - State:NH
Mailing Address - Zip Code:03582-4061
Mailing Address - Country:US
Mailing Address - Phone:603-636-1101
Mailing Address - Fax:603-788-5027
Practice Address - Street 1:47 CHURCH ST
Practice Address - Street 2:
Practice Address - City:GROVETON
Practice Address - State:NH
Practice Address - Zip Code:03582-4061
Practice Address - Country:US
Practice Address - Phone:603-636-1101
Practice Address - Fax:603-788-5027
Is Sole Proprietor?:No
Enumeration Date:2007-12-11
Last Update Date:2008-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1265363AM0700X
NH0693363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT9000394Medicaid
NHQ24163Medicare UPIN
VT9000394Medicaid