Provider Demographics
NPI:1881966802
Name:RAJ, SONAL (PA)
Entity type:Individual
Prefix:
First Name:SONAL
Middle Name:
Last Name:RAJ
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:SONAL
Other - Middle Name:
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:330 W 42ND ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10036-6902
Mailing Address - Country:US
Mailing Address - Phone:901-289-7344
Mailing Address - Fax:
Practice Address - Street 1:330 W 42ND ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10036-6902
Practice Address - Country:US
Practice Address - Phone:901-289-7344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-07
Last Update Date:2016-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant