Provider Demographics
NPI:1851386015
Name:WORNUM, SONIA M (MD)
Entity Type:Individual
Prefix:DR
First Name:SONIA
Middle Name:M
Last Name:WORNUM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:265 POST AVE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590-2233
Mailing Address - Country:US
Mailing Address - Phone:516-333-2440
Mailing Address - Fax:516-333-2716
Practice Address - Street 1:265 POST AVE
Practice Address - Street 2:SUITE 210
Practice Address - City:WESTBURY
Practice Address - State:NY
Practice Address - Zip Code:11590-2233
Practice Address - Country:US
Practice Address - Phone:516-333-2440
Practice Address - Fax:516-333-2716
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-14
Last Update Date:2008-04-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY144921207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY34D601Medicare PIN
NYC08782Medicare UPIN