Provider Demographics
NPI:1770879256
Name:ASMATH, SONY (MBA, ESQ)
Entity type:Individual
Prefix:MR
First Name:SONY
Middle Name:
Last Name:ASMATH
Suffix:
Gender:M
Credentials:MBA, ESQ
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:859 WILLARD ST STE 400
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-7469
Mailing Address - Country:US
Mailing Address - Phone:617-820-9803
Mailing Address - Fax:180-098-5535
Practice Address - Street 1:859 WILLARD ST STE 400
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-7469
Practice Address - Country:US
Practice Address - Phone:617-820-9803
Practice Address - Fax:180-098-5535
Is Sole Proprietor?:No
Enumeration Date:2011-06-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8154171W00000X, 163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
No171W00000XOther Service ProvidersContractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1760916654Medicaid