Healthcare Provider Details

I. General information

NPI: 1003969056
Provider Name (Legal Business Name): PRASHANT SONI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/20/2007
Last Update Date: 01/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 NEWTOWN RD 2C
DANBURY CT
06810-4146
US

IV. Provider business mailing address

107 NEWTOWN RD 2C
DANBURY CT
06810-4146
US

V. Phone/Fax

Practice location:
  • Phone: 203-791-9661
  • Fax: 203-730-4162
Mailing address:
  • Phone: 203-791-9661
  • Fax: 203-730-4162

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number040807
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: