Provider Demographics
NPI:1851352413
Name:SONNETT, MERIDITH (MD)
Entity Type:Individual
Prefix:DR
First Name:MERIDITH
Middle Name:
Last Name:SONNETT
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 1:3959 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-1559
Mailing Address - Country:US
Mailing Address - Phone:212-305-6628
Mailing Address - Fax:212-305-6792
Practice Address - Street 1:3959 BROADWAY
Practice Address - Street 2:COLUMBIA UNVERSITY DEPARTMENT PEDIATRIC
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-1559
Practice Address - Country:US
Practice Address - Phone:221-305-6628
Practice Address - Fax:212-305-6792
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1726452080P0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0204XAllopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01550958Medicaid
NY652Z51Medicare ID - Type Unspecified
NY01550958Medicaid