Provider Demographics
NPI:1265586796
Name:PARK SONODA, M S (MD)
Entity type:Individual
Prefix:
First Name:M
Middle Name:S
Last Name:PARK SONODA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:200 WEST 57TH STREET
Mailing Address - Street 2:SUITE 605
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019
Mailing Address - Country:US
Mailing Address - Phone:212-977-8787
Mailing Address - Fax:212-977-2402
Practice Address - Street 1:142 NORTH CENTRAL AVENUE
Practice Address - Street 2:
Practice Address - City:HARTSDALE
Practice Address - State:NY
Practice Address - Zip Code:10530
Practice Address - Country:US
Practice Address - Phone:914-682-0590
Practice Address - Fax:914-686-3674
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NYNY103194207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology