Provider Demographics
NPI:1811106776
Name:HERBERT, SONJA R
Entity type:Individual
Prefix:MRS
First Name:SONJA
Middle Name:R
Last Name:HERBERT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 W 21ST ST
Mailing Address - Street 2:8TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-6902
Mailing Address - Country:US
Mailing Address - Phone:212-366-4459
Mailing Address - Fax:212-366-1773
Practice Address - Street 1:12 W 21ST ST
Practice Address - Street 2:8TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-6902
Practice Address - Country:US
Practice Address - Phone:212-366-4459
Practice Address - Fax:212-366-1773
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator