Provider Demographics
NPI:1659672087
Name:SONIA GIDWANI, MD, PLLC
Entity type:Organization
Organization Name:SONIA GIDWANI, MD, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SONIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GIDWANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-496-5437
Mailing Address - Street 1:135 WEST 70TH STREET
Mailing Address - Street 2:SUITE 1J
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023
Mailing Address - Country:US
Mailing Address - Phone:212-496-5437
Mailing Address - Fax:866-369-5437
Practice Address - Street 1:135 WEST 70TH STREET
Practice Address - Street 2:SUITE 1J
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023
Practice Address - Country:US
Practice Address - Phone:212-496-5437
Practice Address - Fax:866-369-5437
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-17
Last Update Date:2010-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY192890208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty