Provider Demographics
NPI:1740452903
Name:SONNENBERG, EDITH (MD)
Entity type:Individual
Prefix:DR
First Name:EDITH
Middle Name:
Last Name:SONNENBERG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 RAIDER BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NJ
Mailing Address - Zip Code:08844-1528
Mailing Address - Country:US
Mailing Address - Phone:908-281-0221
Mailing Address - Fax:908-281-0940
Practice Address - Street 1:105 RAIDER BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:HILLSBOROUGH
Practice Address - State:NJ
Practice Address - Zip Code:08844-1528
Practice Address - Country:US
Practice Address - Phone:908-281-0221
Practice Address - Fax:908-281-0940
Is Sole Proprietor?:No
Enumeration Date:2008-03-27
Last Update Date:2010-06-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY239083-1207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ25MA07932900OtherNJ LICENSE