Healthcare Provider Details

I. General information

NPI: 1427525179
Provider Name (Legal Business Name): SONIA IVETTE PLANAS BA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2018
Last Update Date: 10/31/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 GRAND AVENUE
ENGLEWOOD NJ
07631
US

IV. Provider business mailing address

75 GRAND AVE FL 1
ENGLEWOOD NJ
07631-3522
US

V. Phone/Fax

Practice location:
  • Phone: 201-541-8600
  • Fax:
Mailing address:
  • Phone: 201-541-8600
  • Fax: 201-541-8100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: