Provider Demographics
NPI:1881903599
Name:BAWA, SONIA (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:SONIA
Middle Name:
Last Name:BAWA
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 STERLING CIR
Mailing Address - Street 2:
Mailing Address - City:DIX HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11746-6300
Mailing Address - Country:US
Mailing Address - Phone:631-935-4153
Mailing Address - Fax:516-214-8499
Practice Address - Street 1:5 STERLING CIR
Practice Address - Street 2:
Practice Address - City:DIX HILLS
Practice Address - State:NY
Practice Address - Zip Code:11746-6300
Practice Address - Country:US
Practice Address - Phone:631-935-4153
Practice Address - Fax:516-214-8499
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-29
Last Update Date:2010-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008936225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist