Healthcare Provider Details

I. General information

NPI: 1649181629
Provider Name (Legal Business Name): MS. SONIA ANN CARNAZZO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 MILTON ST
LYNN MA
01902-1529
US

IV. Provider business mailing address

36 EVERGREEN ST THIS IS MY HOME ADDRESS NOT A BUSINESS I AM A EMPLOYEE
SAUGUS MA
01906-2041
US

V. Phone/Fax

Practice location:
  • Phone: 781-200-3918
  • Fax:
Mailing address:
  • Phone: 857-417-9259
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: