Provider Demographics
NPI:1295102531
Name:SONZOGNI, ELAINE (MSN, ANP-C)
Entity type:Individual
Prefix:
First Name:ELAINE
Middle Name:
Last Name:SONZOGNI
Suffix:
Gender:F
Credentials:MSN, ANP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 FOREST AVE
Mailing Address - Street 2:
Mailing Address - City:ORADELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07649-1956
Mailing Address - Country:US
Mailing Address - Phone:201-207-7227
Mailing Address - Fax:
Practice Address - Street 1:120 FOREST AVE
Practice Address - Street 2:
Practice Address - City:ORADELL
Practice Address - State:NJ
Practice Address - Zip Code:07649-1956
Practice Address - Country:US
Practice Address - Phone:201-207-7227
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-21
Last Update Date:2015-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00575800363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health