Healthcare Provider Details

I. General information

NPI: 1174197107
Provider Name (Legal Business Name): CHIRAG SONI DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2021
Last Update Date: 10/21/2025
Certification Date: 10/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2103 MOUNT HOLLY RD
BURLINGTON NJ
08016-4157
US

IV. Provider business mailing address

301 LIPPINCOTT DR STE 410
MARLTON NJ
08053-4197
US

V. Phone/Fax

Practice location:
  • Phone: 609-747-9200
  • Fax: 609-747-1408
Mailing address:
  • Phone: 609-747-9200
  • Fax: 609-747-1408

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number25MD00381300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: