Provider Demographics
NPI:1982295465
Name:BRIOSO, SONORA JOY (DPT)
Entity Type:Individual
Prefix:
First Name:SONORA JOY
Middle Name:
Last Name:BRIOSO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:SONORA JOY
Other - Middle Name:
Other - Last Name:VILLANUEVA ALONTO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9420 53RD AVE # 1
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-4612
Mailing Address - Country:US
Mailing Address - Phone:646-457-6541
Mailing Address - Fax:
Practice Address - Street 1:311 SAINT NICHOLAS AVE STE E
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NY
Practice Address - Zip Code:11385-2296
Practice Address - Country:US
Practice Address - Phone:718-509-9888
Practice Address - Fax:718-509-6144
Is Sole Proprietor?:No
Enumeration Date:2021-01-28
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030334225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist