MEDICARE: DR. GIRISHKUMAR SONPAL M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RR0500X	Rheumatology Physician	122605	NY

General Provider Information

NPI Number	:	1447272315
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GIRISHKUMAR SONPAL M.D.

Provider Business Mailing Address
First Line	:	4401 FRANCIS LEWIS BLVD
Second Line	:	SUITE L2A
City	:	BAYSIDE
State	:	NY
Zip	:	11361-3028
Country	:	US
Telephone Number	:	718-445-0500
Fax Number	:	718-717-0286

Provider Business Practice Location Address
First Line	:	4401 FRANCIS LEWIS BLVD
Second Line	:	SUITE L2A
City	:	BAYSIDE
State	:	NY
Zip	:	11361-3028
Country	:	US
Telephone Number	:	718-445-0500
Fax Number	:	718-717-0286

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/23/2006
Last Update Date	:	01/09/2017

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