Provider Demographics
NPI:1942271325
Name:SOJA, DARLENE A (PA-C)
Entity Type:Individual
Prefix:
First Name:DARLENE
Middle Name:A
Last Name:SOJA
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 1:819 WORCESTER ST 3
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01151-1056
Mailing Address - Country:US
Mailing Address - Phone:413-543-6820
Mailing Address - Fax:413-543-7962
Practice Address - Street 1:14 CHESTNUT PLACE
Practice Address - Street 2:
Practice Address - City:LUDLOW
Practice Address - State:MA
Practice Address - Zip Code:01056
Practice Address - Country:US
Practice Address - Phone:413-589-7581
Practice Address - Fax:413-547-2738
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2015-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1294363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
P39213Medicare UPIN
MAAP1537Medicare ID - Type Unspecified