Healthcare Provider Details

I. General information

NPI: 1487870101
Provider Name (Legal Business Name): SONIA HEGDE D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2007
Last Update Date: 12/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

46 PRINCE ST SUITE 302
NEW HAVEN CT
06519-1600
US

IV. Provider business mailing address

25 GERMANTOWN RD SUITE 1A
DANBURY CT
06810-5036
US

V. Phone/Fax

Practice location:
  • Phone: 203-772-0011
  • Fax: 203-785-9352
Mailing address:
  • Phone: 203-794-5620
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number248820
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number049943
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: