Provider Demographics
NPI:1750537239
Name:JOHN, SONIA S (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:SONIA
Middle Name:S
Last Name:JOHN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 HAWKINS DR
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:NY
Mailing Address - Zip Code:12549-2626
Mailing Address - Country:US
Mailing Address - Phone:845-457-3023
Mailing Address - Fax:
Practice Address - Street 1:103 HAWKINS DR
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:NY
Practice Address - Zip Code:12549-2626
Practice Address - Country:US
Practice Address - Phone:845-457-3023
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-15
Last Update Date:2010-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY054155183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist