Provider Demographics
NPI:1952706293
Name:SONIA Y KRAGH, MD, PC
Entity Type:Organization
Organization Name:SONIA Y KRAGH, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIFDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SONIA
Authorized Official - Middle Name:Y
Authorized Official - Last Name:KRAGH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:315-882-6856
Mailing Address - Street 1:5800 HERITAGE LANDING DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:EAST SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13057-9378
Mailing Address - Country:US
Mailing Address - Phone:315-882-6856
Mailing Address - Fax:315-445-2847
Practice Address - Street 1:5800 HERITAGE LANDING DR
Practice Address - Street 2:SUITE C
Practice Address - City:EAST SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13057-9378
Practice Address - Country:US
Practice Address - Phone:315-882-6856
Practice Address - Fax:315-445-2847
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-29
Last Update Date:2014-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY177380207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty