Provider Demographics
NPI:1942998315
Name:SONQUIT, MARYJONILYN SEVILLA (LPN)
Entity Type:Individual
Prefix:
First Name:MARYJONILYN
Middle Name:SEVILLA
Last Name:SONQUIT
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:429 FAIRMOUNT AVE APT 203
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306-5912
Mailing Address - Country:US
Mailing Address - Phone:323-382-2161
Mailing Address - Fax:
Practice Address - Street 1:337 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07307-2919
Practice Address - Country:US
Practice Address - Phone:201-653-0357
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-25
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NP49529600164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse