Provider Demographics
NPI:1649432956
Name:GARG, SONA MALKANI (DO)
Entity type:Individual
Prefix:
First Name:SONA
Middle Name:MALKANI
Last Name:GARG
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 1:609 W GERMANTOWN PIKE
Mailing Address - Street 2:SUITE 205 BRAEMER BUILDING
Mailing Address - City:EAST NORRITON
Mailing Address - State:PA
Mailing Address - Zip Code:19403-4243
Mailing Address - Country:US
Mailing Address - Phone:484-622-7084
Mailing Address - Fax:
Practice Address - Street 1:609 W GERMANTOWN PIKE
Practice Address - Street 2:SUITE 205 BRAEMER BUILDING
Practice Address - City:EAST NORRITON
Practice Address - State:PA
Practice Address - Zip Code:19403-4243
Practice Address - Country:US
Practice Address - Phone:484-622-7084
Practice Address - Fax:484-622-7090
Is Sole Proprietor?:No
Enumeration Date:2008-06-27
Last Update Date:2017-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS015354207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA225735Medicare PIN