Provider Demographics
NPI:1821062076
Name:YOUNGREN, SONYA (MD)
Entity Type:Individual
Prefix:
First Name:SONYA
Middle Name:
Last Name:YOUNGREN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 594
Mailing Address - Street 2:
Mailing Address - City:EAST HANOVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07936-0594
Mailing Address - Country:US
Mailing Address - Phone:973-669-5711
Mailing Address - Fax:973-669-5722
Practice Address - Street 1:75 E NORTHFIELD RD
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-4532
Practice Address - Country:US
Practice Address - Phone:973-436-1410
Practice Address - Fax:973-379-4724
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06815400207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJH40842Medicare UPIN
NJ0855590AUKMedicare ID - Type Unspecified