Provider Demographics
NPI:1184789778
Name:WALKER-ADAMSON, SONIA EVADNE (DO)
Entity type:Individual
Prefix:DR
First Name:SONIA
Middle Name:EVADNE
Last Name:WALKER-ADAMSON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7114
Mailing Address - Street 2:
Mailing Address - City:HICKSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11802-7114
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:114 - 81 177 PLACE
Practice Address - Street 2:
Practice Address - City:ST. ALBANS
Practice Address - State:NY
Practice Address - Zip Code:11434
Practice Address - Country:US
Practice Address - Phone:718-658-6767
Practice Address - Fax:718-206-0861
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-26
Last Update Date:2016-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY197679207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1306019765OtherHEALTH & WELLNESS FAMILY PRACTICE SERVICE PC NPI #
NY01580318Medicaid
NY01818OtherMEDICARE LEGACY #
NY1407029861OtherHEALTH CARE AND FAMILY MEDICINE PC NPI #
NY753221864OtherHEALTH CARE AND FAMILY MEDICINE PC EIN #
NY113279162OtherHEALTH & WELLNESS FAMILY PRACTICE SERVICE PC EIN #
NY113279162OtherHEALTH & WELLNESS FAMILY PRACTICE SERVICE PC EIN #
NY01580318Medicaid