Provider Demographics
NPI:1023423464
Name:NASERY, SONIA
Entity type:Individual
Prefix:
First Name:SONIA
Middle Name:
Last Name:NASERY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1004 SUSHRUTA DR STE A
Mailing Address - Street 2:
Mailing Address - City:MARTINSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:25401-8801
Mailing Address - Country:US
Mailing Address - Phone:571-502-1340
Mailing Address - Fax:
Practice Address - Street 1:1004 SUSHRUTA DR STE A
Practice Address - Street 2:
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25401-8801
Practice Address - Country:US
Practice Address - Phone:571-502-1340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-24
Last Update Date:2021-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA380905207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty