Provider Demographics
NPI:1881946119
Name:SEBASTIAN, SONIA (NURSE PRACTITIONER)
Entity type:Individual
Prefix:MS
First Name:SONIA
Middle Name:
Last Name:SEBASTIAN
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 PONDFIELD RD
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:BRONXVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10708-3809
Mailing Address - Country:US
Mailing Address - Phone:914-771-9286
Mailing Address - Fax:914-771-5182
Practice Address - Street 1:77 PONDFIELD RD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:BRONXVILLE
Practice Address - State:NY
Practice Address - Zip Code:10708-3809
Practice Address - Country:US
Practice Address - Phone:914-771-9286
Practice Address - Fax:914-771-5182
Is Sole Proprietor?:No
Enumeration Date:2012-10-10
Last Update Date:2012-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF337447363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily